Wang Y L, Tan P P, Yang C H, Tsai S C, Chung H S
Department of Anaesthesia, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Anesth Analg. 1997 Feb;84(2):376-8. doi: 10.1097/00000539-199702000-00025.
We performed a prospective, randomized, double-blind study to compare the effect of epidural dexamethasone on the incidence of postepidural backache after nonobstetric surgery. One thousand unpremedicated ASA physical status I or II patients scheduled for hemorrhoidectomy were randomly assigned to two groups: Group I patients received 25 mL 2% lidocaine with epinephrine 1:200,000 and 1 mL dexamethasone (5 mg) epidurally. Patients were interviewed at 24,48, and 72 h postoperatively using a standard visual analog scale (VAS) for evaluation of postepidural backache. A patient was considered to have postepidural backache when the postoperative VAS score was higher than the preoperative score. The incidence of postepidural backache in Group I patients for the 3 days were 22.8%, 17.4%, and 9.2%, all of which were significantly more frequent than observed in Group II patients (7.4%,5.6%, and 2.8%, P < 0.01). The severity and duration of postepidural backache were also significantly decreased in Group II patients. In our study, there was a significant association between postepidural backache and multiple attempts at epidural needle insertion. In summary, epidural dexamethasone reduced the incidence and severity of postepidural backache.
我们进行了一项前瞻性、随机、双盲研究，以比较硬膜外注射地塞米松对非产科手术后硬膜外背痛发生率的影响。1000例计划行痔切除术、未使用术前药的美国麻醉医师协会（ASA）身体状况I或II级患者被随机分为两组：第一组患者硬膜外注射25 mL含1:200,000肾上腺素的2%利多卡因和1 mL地塞米松（5 mg）。术后24、48和72小时使用标准视觉模拟量表（VAS）对患者进行访谈，以评估硬膜外背痛情况。当术后VAS评分高于术前评分时，患者被认为患有硬膜外背痛。第一组患者术后3天硬膜外背痛的发生率分别为22.8%、17.4%和9.2%，均显著高于第二组患者（7.4%、5.6%和2.8%，P<0.01）。第二组患者硬膜外背痛的严重程度和持续时间也显著降低。在我们的研究中，硬膜外背痛与多次硬膜外穿刺尝试之间存在显著关联。总之，硬膜外注射地塞米松降低了硬膜外背痛的发生率和严重程度。
