Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax, Tunisia.
Faculty of Medicine, University of Sfax, Sfax, Tunisia.
Pan Afr Med J. 2022 Jul 8;42:190. doi: 10.11604/pamj.2022.42.190.32171. eCollection 2022.
we evaluate the effectiveness of lidocaine infusion compared to the intravenous dexamethasone and placebo on postoperative vomiting and first oral intake in children post tonsillectomy.
we conducted a prospective double-blinded randomized and controlled clinical trial involving children aged between 3 and 13 years proposed for elective tonsillectomy without or with adenoidectomy under general anesthesia. They were randomized into 3 groups: lidocaine group included patients who received intravenous bolus of 2 mg/kg lidocaine over 5 minutes after the induction of anesthesia. Then, they received an infusion of 1.5 mg/kg/h until the end of the surgical procedure, dexamethasone group included patients who received intravenous dexamethasone 0.15 mg/kg administrated over 5 minutes after the induction of anesthesia followed by an identical rate of 0.9% saline and the saline group included patients who received an equivalent volume of 0.9% saline. For data analysis, we tested the normality of variables using the Shapiro-Wilk test. We used analysis of variance (ANOVA) or the Kruskal-Wallis test for between-group comparisons, as appropriate. The X test and Fisher´s exact test were used for inferences on proportions. A two-sided P-value was considered significant when p≤0.05. All analyses were performed with IBM SPSS≤ 25.0.0 for windows.
eighty-three (83) children were analyzed in our study and randomized into 3 groups: 27 children for each lidocaine and dexamethasone group and 29 children for the Saline group. The demographic data were not significantly different between the three groups such as age (p=0.246), gender (p=0.378), and body mass index (BMI) with p=0.233. The duration of surgery and anesthesia was also comparable in the 3 groups (p=0.893). Patients of the lidocaine and dexamethasone group had at least one episode of retching, vomiting, or both less than the saline group in the post-anesthetic care unit with p respectively 0.015 and 0,035, and in the ward with p respectively 0.004 and 0,038 Without a significant difference between the dexamethasone and the lidocaine group. The time to the first oral intake was significantly shorter in the dexamethasone group and the lidocaine group compared with the saline group (p=0.0001) with no statistical difference between the dexamethasone and lidocaine groups.
lidocaine infusion is as effective as intravenous dexamethasone on postoperative vomiting as well as on oral intake in children post tonsillectomy.
我们评估了利多卡因输注与静脉注射地塞米松和安慰剂在小儿扁桃体切除术后呕吐和首次口服方面的效果。
我们进行了一项前瞻性、双盲、随机对照临床试验，涉及年龄在 3 至 13 岁之间的儿童，这些儿童拟在全身麻醉下进行择期扁桃体切除术，不伴或伴腺样体切除术。他们被随机分为 3 组：利多卡因组患者在麻醉诱导后 5 分钟内静脉推注 2mg/kg 利多卡因，然后以 1.5mg/kg/h 的速度输注至手术结束。地塞米松组患者在麻醉诱导后 5 分钟内静脉注射 0.15mg/kg 地塞米松，然后以相同速度输注 0.9%生理盐水，盐水组患者接受等量 0.9%生理盐水。对于数据分析，我们使用 Shapiro-Wilk 检验测试变量的正态性。我们使用方差分析（ANOVA）或 Kruskal-Wallis 检验进行组间比较，根据需要进行。X 检验和 Fisher 确切检验用于比例推断。当 p≤0.05 时，双侧 P 值被认为具有统计学意义。所有分析均使用 IBM SPSS≤25.0.0 for windows 进行。
本研究共分析了 83 例儿童，并随机分为 3 组：每组 27 例利多卡因和地塞米松组，29 例盐水组。三组间的人口统计学数据无显著差异，如年龄（p=0.246）、性别（p=0.378）和体重指数（BMI），p=0.233。三组的手术和麻醉时间也相似（p=0.893）。利多卡因和地塞米松组患者在麻醉后护理单元（p 分别为 0.015 和 0.035）和病房（p 分别为 0.004 和 0.038）中至少有一次呕吐、呕吐或两者兼有，少于盐水组，且地塞米松组和利多卡因组之间无显著差异。与盐水组相比，地塞米松组和利多卡因组首次口服的时间明显缩短（p=0.0001），地塞米松组和利多卡因组之间无统计学差异。
利多卡因输注与静脉注射地塞米松在小儿扁桃体切除术后呕吐和口服方面同样有效。
