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术前地塞米松对扁桃体切除术患者术后疼痛的影响。

Effect of Preoperative Dexamethasone on Postoperative Pain in Patients Undergoing Tonsillectomy.

作者信息

Malhotra Vibhor, Kumar Vivek

机构信息

MS ENT, Otology & Hearing Implant Fellow Apollo Bannerghatta, Bangalore, India.

MS, DNB ENT, Department Of ENT PMCH, Patna, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):249-254. doi: 10.1007/s12070-022-03195-x. Epub 2022 Oct 6.

Abstract

Tonsillectomy is one of the most commonly performed surgical procedures worldwide. Postoperative pain remains a significant problem for patients undergoing tonsillectomy and is the most typical reason for readmission after the procedure. We conducted the present study to investigate the efficacy of a single dose of dexamethasone administered intravenously before tonsillectomy on postoperative pain in a group of patients undergoing cold dissection tonsillectomy, using a standardised anaesthetic and surgical procedure.It was a prospective study done in the Department of ENT in a tertiary care centre in eastern India, from 1 st September 2017 to 31 st August 2019 (2 years). Subjects included in the study were patients who attended the OPD of ENT of the tertiary care centre in eastern India, with a history of throat pain,difficulty in deglutition, mouth breathing, snoring. Tonsillectomy operation was recommended to the patients who fit the inclusion criteria. A hundred patients were selected for the study and divided randomly into two groups. Patients in group A (50 patients) were administered preoperative intravenous dexamethasone (0.15 mg/kg)after the induction of anaesthesia, and Group B patients (50 patients)were not administered dexamethasone along with other drugs.RESULTS: A hundred patients were enrolled after excluding the patients not fulfilling the selection criteria. The majority of patients were female, with the majority patients between 9-19 years. There was a noteworthy decreased mean pain score postoperatively of Group A on the first, third, and fifth day. (-value = < 0.001).The results of this study suggest that a single preoperative injection of dexamethasone for patients undergoing tonsillectomy by cold dissection method significantly reduced postoperative pain.

摘要

扁桃体切除术是全球最常开展的外科手术之一。术后疼痛仍是接受扁桃体切除术患者的一个重大问题,也是该手术后再次入院的最常见原因。我们开展了本研究,采用标准化麻醉和手术程序,调查扁桃体切除术前行单次静脉注射地塞米松对一组接受冷剥离扁桃体切除术患者术后疼痛的疗效。

这是一项前瞻性研究,于2017年9月1日至2019年8月31日(2年)在印度东部一家三级护理中心的耳鼻喉科进行。纳入研究的对象是到印度东部三级护理中心耳鼻喉科门诊就诊、有咽痛、吞咽困难、张口呼吸、打鼾病史的患者。符合纳入标准的患者被建议行扁桃体切除术。选取100例患者进行研究并随机分为两组。A组(50例患者)在麻醉诱导后给予术前静脉注射地塞米松(0.15mg/kg),B组患者(50例患者)不给予地塞米松及其他药物。

结果

排除不符合入选标准的患者后,共纳入100例患者。大多数患者为女性,大多数患者年龄在9至19岁之间。A组术后第一天、第三天和第五天的平均疼痛评分显著降低(P值=<0.001)。本研究结果表明,对于采用冷剥离法行扁桃体切除术的患者,术前单次注射地塞米松可显著减轻术后疼痛。

相似文献

1
Effect of Preoperative Dexamethasone on Postoperative Pain in Patients Undergoing Tonsillectomy.
Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):249-254. doi: 10.1007/s12070-022-03195-x. Epub 2022 Oct 6.
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本文引用的文献

1
A Randomized Controlled Trial on Analgesic Effects of Intravenous Acetaminophen versus Dexamethasone after Pediatric Tonsillectomy.
Iran Red Crescent Med J. 2013 Nov;15(11):e9267. doi: 10.5812/ircmj.9267. Epub 2013 Nov 5.
3
Effect of dexamethasone on nausea, vomiting, and pain in paediatric tonsillectomy.
Br J Anaesth. 2012 Sep;109(3):427-31. doi: 10.1093/bja/aes249.
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Perioperative single-dose glucocorticoid administration: pathophysiologic effects and clinical implications.
J Am Coll Surg. 2002 Nov;195(5):694-712. doi: 10.1016/s1072-7515(02)01491-6.
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Laryngoscope. 2001 Oct;111(10):1712-8. doi: 10.1097/00005537-200110000-00008.
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The effect of dexamethasone on postoperative vomiting after tonsillectomy.
Anesth Analg. 2001 Mar;92(3):636-40. doi: 10.1097/00000539-200103000-00015.

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