Aasboe V, Raeder J C, Groegaard B
Department of Anesthesia, Ullevaal University Hospital, Oslo, Norway.
Anesth Analg. 1998 Aug;87(2):319-23. doi: 10.1097/00000539-199808000-00015.
The aims of this study were to evaluate the effects of a single-dose glucocorticoid on the incidence and severity of pain and nausea and vomiting (PONV) after ambulatory surgery. Seventy-eight ASA physical status I-III patients scheduled for hemorrhoidectomy or hallux valgus correction were studied using a randomized, double-blind, placebo-controlled protocol. One group received 12 mg of betamethasone i.m. 30 min before the start of surgery (Group B), whereas the placebo group (Group P) received saline. General anesthesia was induced with propofol and fentanyl and maintained with isoflurane in both groups. Pain (measured using a visual analog scale, verbal score, and analgesic requirements), PONV, and other side effects were evaluated postoperatively. Patients in Group B experienced significantly less postoperative pain, less PONV, and better patient satisfaction during the first 24 h after surgery. In conclusion, a single dose of betamethasone (12 mg) seemed to produce analgesic and antiemetic effects after day-case surgery.
In a placebo-controlled study, the use of corticosteroid prophylaxis (betamethasone) produced a significant reduction in both postoperative pain and nausea in outpatients who received the corticosteroid injection before ambulatory foot or hemorrhoid operations.
本研究旨在评估单剂量糖皮质激素对门诊手术后疼痛、恶心和呕吐（PONV）的发生率及严重程度的影响。采用随机、双盲、安慰剂对照方案，对78例计划行痔切除术或拇外翻矫正术的美国麻醉医师协会（ASA）身体状况I-III级患者进行了研究。一组在手术开始前30分钟肌肉注射12毫克倍他米松（B组），而安慰剂组（P组）注射生理盐水。两组均采用丙泊酚和芬太尼诱导全身麻醉，并用异氟烷维持麻醉。术后评估疼痛（采用视觉模拟评分、言语评分和镇痛需求进行测量）、PONV及其他副作用。B组患者在术后24小时内的术后疼痛明显减轻，PONV减少，患者满意度更高。总之，单剂量倍他米松（12毫克）似乎在日间手术术后产生了镇痛和止吐作用。
在一项安慰剂对照研究中，对于在门诊足部或痔手术前行糖皮质激素注射的门诊患者，使用糖皮质激素预防（倍他米松）可显著降低术后疼痛和恶心的发生率。
