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地塞米松降低了扁桃体切除术的术后并发症。

Dexamethasone Decreased Postoperative Complications in Tonsillotomy.

机构信息

Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Department of Otolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

J Perianesth Nurs. 2024 Feb;39(1):79-81. doi: 10.1016/j.jopan.2023.06.093. Epub 2023 Oct 17.

DOI:10.1016/j.jopan.2023.06.093
PMID:37855764
Abstract

PURPOSE

Tonsillotomy (TT) is a new and popular method with partial resection of the tonsils. Dexamethasone is often used during surgery for its anti-inflammatory, antiemetic, and analgesic properties. In this study, we aimed to explore the effect of systemic steroids use on postoperative vomiting, pain, and bleeding in TT.

DESIGN

A randomized controlled trial.

METHODS

We enrolled 240 children aged 2 to 18 years who had undergone TT or adenotonsillotomy at our center from July 2020 to July 2021. Dexamethasone or 0.9% normal saline was administered before the start of surgery. Postoperative hemorrhage, vomiting, and nausea were recorded and compared between groups.

FINDINGS

The dexamethasone group had a 2.5% (3/119) rate of postoperative bleeding, while the rate was 1.6% (2/119) in the control group. No patients required multiple operations for control of bleeding. The degree of postoperative pain (2.1 ± 0.5 vs 3.4 ± 0.9) and the occurrence of postoperative nausea (21% vs 31.9%), as well as vomiting (15% vs 24.4%) in the dexamethasone group, was significantly lower compared with the placebo group.

CONCLUSIONS

The rate of postoperative bleeding between the dexamethasone group and the control group had no significant difference, suggesting the high safety of dexamethasone use in TT. Dexamethasone use in TT improved postoperative pain, nausea, and vomiting significantly.

摘要

目的

扁桃体切除术(TT)是一种具有部分扁桃体切除术的新方法,越来越受欢迎。地塞米松因其具有抗炎、止吐和镇痛作用,常在手术中使用。本研究旨在探讨全身类固醇使用对 TT 术后呕吐、疼痛和出血的影响。

设计

随机对照试验。

方法

我们招募了 240 名年龄在 2 至 18 岁之间的儿童,他们于 2020 年 7 月至 2021 年 7 月在我们中心接受了 TT 或扁桃体腺样体切除术。地塞米松或 0.9%生理盐水在手术开始前给予。记录并比较两组术后出血、呕吐和恶心的情况。

发现

地塞米松组术后出血率为 2.5%(3/119),对照组为 1.6%(2/119)。无患者需要多次手术控制出血。地塞米松组术后疼痛程度(2.1±0.5 与 3.4±0.9)、术后恶心(21%与 31.9%)和呕吐(15%与 24.4%)的发生率明显低于安慰剂组。

结论

地塞米松组和对照组术后出血率无显著差异,提示 TT 中使用地塞米松安全性高。TT 中使用地塞米松可显著改善术后疼痛、恶心和呕吐。

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