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地塞米松对甲状腺手术后疼痛控制的影响：一项随机对照试验的荟萃分析。

The effect of dexamethasone on pain control after thyroid surgery: a meta-analysis of randomized controlled trials.

机构信息

Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Department of General Surgery (Thyroid Surgery), Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.

Hospital of Traditional Chinese Medicine affiliated to Southwest Medical University, Luzhou, 646000, China.

出版信息

Eur Arch Otorhinolaryngol. 2021 Jun;278(6):1957-1964. doi: 10.1007/s00405-020-06245-8. Epub 2020 Aug 17.

DOI:10.1007/s00405-020-06245-8
PMID:32804272
Abstract

INTRODUCTION

The effect of dexamethasone on postoperative pain after thyroid surgery remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexamethasone versus placebo on postoperative pain after thyroid surgery.

METHODS

We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2020 for randomized controlled trials (RCTs) assessing the effect of dexamethasone versus placebo on postoperative pain after thyroid surgery. This meta-analysis is performed using the random-effect model.

RESULTS

Eight RCTs involving 734 patients are included in the meta-analysis. Overall, compared with control group for thyroid surgery, dexamethasone shows significantly reduced pain scores (SMD = - 0.82; 95% CI - 1.08 to - 0.56; P < 0.00001), number of required analgesics (OR = 0.18; 95% CI 0.11-0.31; P < 0.00001), analgesic consumption (SMD = - 0.38; 95% CI - 0.63 to - 0.13; P = 0.003), nausea and vomiting (OR = 0.38; 95% CI 0.17-0.86; P = 0.02), as well as rescue antiemetics (OR = 0.40; 95% CI 0.20-0.79; P = 0.008).

CONCLUSIONS

Perioperative dexamethasone is effective to reduce the pain, nausea and vomiting after thyroid surgery.

摘要

简介

地塞米松对甲状腺手术后疼痛的影响仍存在争议。我们进行了一项系统评价和荟萃分析，以探讨地塞米松与安慰剂对甲状腺手术后疼痛的影响。

方法

我们通过检索 PubMed、EMbase、Web of Science、EBSCO 和 Cochrane 图书馆数据库，查找评估地塞米松与安慰剂对甲状腺手术后疼痛影响的随机对照试验（RCT），检索时间截至 2020 年 5 月。本荟萃分析采用随机效应模型进行。

结果

共纳入 8 项 RCT 研究，涉及 734 例患者。总体而言，与甲状腺手术对照组相比，地塞米松可显著降低疼痛评分（SMD=-0.82；95%CI-1.08 至-0.56；P<0.00001）、所需镇痛药的数量（OR=0.18；95%CI0.11-0.31；P<0.00001）、镇痛药的使用量（SMD=-0.38；95%CI-0.63 至-0.13；P=0.003）、恶心呕吐（OR=0.38；95%CI0.17-0.86；P=0.02）以及止吐药的使用（OR=0.40；95%CI0.20-0.79；P=0.008）。

结论

围手术期使用地塞米松可有效减轻甲状腺手术后的疼痛、恶心和呕吐。

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Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): From A to Z.经口内镜甲状腺手术前庭入路（TOETVA）：从A到Z
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