地塞米松含漱、静脉注射地塞米松及其联合应用对术后咽痛的影响:一项随机对照试验。

Effect of dexamethasone gargle, intravenous dexamethasone, and their combination on postoperative sore throat: a randomized controlled trial.

作者信息

Ki Seunghee, Myoung Inwook, Cheong Soonho, Lim Sehun, Cho Kwangrae, Kim Myoung-Hun, Han Yongjae, Oh Minkyung, Park Yohan, Kim Kwanghee, Lee Jeonghan

机构信息

Department of Anesthesiology and Pain Medicine, Inje University College of Medicine, Busan, Korea.

Department of Pharmacology, Inje University College of Medicine, Busan, Korea.

出版信息

Anesth Pain Med (Seoul). 2020 Oct 30;15(4):441-450. doi: 10.17085/apm.20057.

Abstract

BACKGROUND

Postoperative sore throat (POST) is a complication that decreases patient satisfaction and increases postoperative complaints. The present study was conducted to investigate effects of gargling with dexamethasone, intravenous dexamethasone injection and the combination of the two on the incidence and severity of POST.

METHODS

Study participants were 96 patients who had undergone laparoscopic cholecystectomy, randomly allocated into three groups. Group G gargled with 0.05% dexamethasone solution and were infused intravenous 0.9% normal saline before general anesthesia; group I gargled with 0.9% normal saline and were infused intravenous 0.1 mg/kg dexamethasone; group GI gargled with 0.05% dexamethasone solution and were infused intravenous 0.1 mg/kg dexamethasone. The incidence and severity of POST, hoarseness and cough were evaluated and recorded at 1, 6, and 24 h after the surgery.

RESULTS

There were no significant differences in the total incidence of POST up to 24 postoperative hours among Group G, Group I and Group GI (P = 0.367, Group G incidence = 34.38%, [95% confidence interval, 95% CI = 17.92-50.83], Group I incidence = 18.75%, [95% CI = 5.23-32.27], Group GI incidence = 28.13%, [95% CI = 12.55-43.70]). The other outcomes were comparable among the groups.

CONCLUSIONS

In patients who had undergone laparoscopic cholecystectomy, gargling with 0.05% dexamethasone solution demonstrated the same POST prevention effect as intravenous injection of 0.1 mg/kg dexamethasone. The incidence and severity of POST were not significantly different between the combination of gargling with 0.05% dexamethasone solution and intravenous injection of 0.1 mg/kg dexamethasone and use of each of the preventive methods alone.

摘要

背景

术后咽痛(POST)是一种会降低患者满意度并增加术后不适主诉的并发症。本研究旨在探讨地塞米松含漱、静脉注射地塞米松以及两者联合应用对POST发生率和严重程度的影响。

方法

研究对象为96例行腹腔镜胆囊切除术的患者,随机分为三组。G组在全身麻醉前用0.05%地塞米松溶液含漱并静脉输注0.9%生理盐水;I组用0.9%生理盐水含漱并静脉输注0.1mg/kg地塞米松;GI组用0.05%地塞米松溶液含漱并静脉输注0.1mg/kg地塞米松。在术后1小时、6小时和24小时评估并记录POST、声音嘶哑和咳嗽的发生率及严重程度。

结果

G组、I组和GI组术后24小时内POST的总发生率无显著差异(P = 0.367,G组发生率 = 34.38%,[95%置信区间,95%CI = 17.92 - 50.83],I组发生率 = 18.75%,[95%CI = 5.23 - 32.27],GI组发生率 = 28.13%,[95%CI = 12.55 - 43.70])。其他结果在各组间具有可比性。

结论

在接受腹腔镜胆囊切除术的患者中,用0.05%地塞米松溶液含漱预防POST的效果与静脉注射0.1mg/kg地塞米松相同。0.05%地塞米松溶液含漱与静脉注射0.1mg/kg地塞米松联合应用预防POST的发生率和严重程度与单独使用每种预防方法相比无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b71/7724117/a31f9d505dd4/apm-20057f1.jpg

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