在埃塞俄比亚亚的斯亚贝巴的提库尔·安贝萨专科医院和耶卡蒂特12医院，丙泊酚与地塞米松预防耳鼻喉科手术后恶心呕吐的效果比较

Effectiveness of Propofol versus Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Ear, Nose, and Throat Surgery in Tikur Anbessa Specialized Hospital and Yekatit 12th Hospital, Addis Ababa, Ethiopia.

作者信息

Tilahun Bantie Abere, Admasu Wosenyeleh, Mulugeta Sintayehu, Bacha Abera Regassa, Getnet Demsie Desalegn

机构信息

Department of Anesthesiology, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia.

School of Anesthesiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Anesthesiol Res Pract. 2020 Sep 7;2020:4258137. doi: 10.1155/2020/4258137. eCollection 2020.

DOI:10.1155/2020/4258137

PMID:32963522

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7492878/

Abstract

BACKGROUND

Postoperative nausea and vomiting (PONV) remain as common and unpleasant and highly distressful experience following ear, nose, and throat surgery. During ENT surgery, the incidence of PONV could be significantly reduced in patients who receive dexamethasone and propofol as prophylaxis. However, the comparative effectiveness of the two drugs has not been assessed. The aim of this study was to compare the effectiveness of propofol and dexamethasone for prevention of PONV in ear, nose, and throat surgery.

METHODS

This study was conducted in 80 patients, with ASA I and II, aged 18-65 years, and scheduled for ENT surgery between December 20, 2017, and March 20, 2018. Patients were randomly assigned to Group A and Group B. Immediately after the procedure, Group A patients received single dose of intravenous (IV) dexamethasone (10 mg/kg) and Group B patients were given propofol (0.5 mg/kg, IV), and equal follow-up was employed. The incidence of PONV was noted at 6th, 12th, and 24th hour of drug administration. Independent -test and Mann-Whitney test were used for comparison of symmetric numerical and asymmetric data between groups, respectively. Categorical data were analyzed with the chi-square test, and value of < 0.05 was considered as level of significance.

RESULTS

The incidences of PONV throughout the 24-hour postoperative period were 35% in the propofol group and 25% in the dexamethasone group. Statistical significance was found in incidence of PONV (0% versus 22.5%) and use of antiemetic (0% versus 5%) between dexamethasone and propofol groups, respectively, at 12-24 hours. Over 24 hours, 5% in dexamethasone group and 12.5% in propofol group developed moderate PONV, while none of the participants felt severe PONV.

CONCLUSIONS

Dexamethasone was more effective than propofol to prevent PONV with lower requirements of rescue antiemetics.

摘要

背景

术后恶心呕吐（PONV）仍是耳鼻喉科手术后常见、令人不适且极为痛苦的经历。在耳鼻喉科手术中，接受地塞米松和丙泊酚预防的患者，PONV的发生率可显著降低。然而，这两种药物的相对有效性尚未得到评估。本研究的目的是比较丙泊酚和地塞米松在耳鼻喉科手术中预防PONV的有效性。

方法

本研究纳入了80例年龄在18 - 65岁、ASA分级为I级和II级、计划于2017年12月20日至2018年3月20日进行耳鼻喉科手术的患者。患者被随机分为A组和B组。手术后，A组患者立即接受单剂量静脉注射（IV）地塞米松（10mg/kg），B组患者给予丙泊酚（0.5mg/kg，IV），并进行同等的随访。在给药后第6、12和24小时记录PONV的发生率。分别采用独立样本t检验和曼-惠特尼检验比较组间对称数值数据和非对称数据。分类数据采用卡方检验分析，P值<0.05被视为具有统计学意义。

结果

术后24小时内，丙泊酚组PONV的发生率为35%，地塞米松组为25%。在12 - 24小时时，地塞米松组和丙泊酚组在PONV发生率（0%对22.5%）和使用止吐药方面（0%对5%）分别具有统计学意义。在24小时内，地塞米松组5%的患者和丙泊酚组12.5%的患者出现中度PONV，而没有参与者感到严重PONV。