Sato Takehito
Department of Anesthesiology, Nagoya University Hospital, Nagoya City, Aichi, 466-8550, Japan.
JA Clin Rep. 2024 Oct 7;10(1):63. doi: 10.1186/s40981-024-00746-9.
Nausea and vomiting during awake craniotomy (AC) can increase cerebral pressure and cause asphyxia and aspiration. 5-HT3 receptor antagonists, such as granisetron, are often administered before awakening to prevent nausea during AC. Recently, dexamethasone was reported to prevent nausea and vomiting during AC; however, the efficacy of both drugs in preventing nausea has not yet been investigated.
We examined the frequency of nausea and vomiting in AC patients (n = 170) treated at our hospital until the end of September 2019. We divided patients as those who received dexamethasone (n = 71) and or granisetron (n = 99) before awakening and examined the frequency of nausea and vomiting after propensity score (PS) matching.
Eighty-two patients were selected after PS matching. The incidence of nausea was significantly lower in the dexamethasone group than in the granisetron group (9.8% vs 41.5%, p = 0.002). In the logistic regression analysis after matching, the incidence of nausea significantly reduced with dexamethasone treatment (odds ratio: 0.12, 95% confidence interval: 0.029-0.499, p = 0.03).
In conclusion, dexamethasone was more effective than granisetron in preventing nausea during AC.
清醒开颅手术（AC）期间的恶心和呕吐会增加颅内压，并导致窒息和误吸。5-羟色胺3（5-HT3）受体拮抗剂，如格拉司琼，常在苏醒前给药以预防AC期间的恶心。最近，有报道称地塞米松可预防AC期间的恶心和呕吐；然而，这两种药物预防恶心的疗效尚未得到研究。
我们调查了截至2019年9月底在我院接受治疗的AC患者（n = 170）恶心和呕吐的发生率。我们将患者分为在苏醒前接受地塞米松治疗的患者（n = 71）和或格拉司琼治疗的患者（n = 99），并在倾向得分（PS）匹配后检查恶心和呕吐的发生率。
PS匹配后选择了82例患者。地塞米松组的恶心发生率显著低于格拉司琼组（9.8%对41.5%，p = 0.002）。匹配后的逻辑回归分析显示，地塞米松治疗可显著降低恶心发生率（比值比：0.12，95%置信区间：0.029 - 0.499，p = 0.03）。
总之, 地塞米松在预防AC期间的恶心方面比格拉司琼更有效。
