Prevention of PONV with Dexamethasone in Female Patients Undergoing Desflurane Anesthesia for Thyroidectomy

Dexamethasone對女性患者在接受Desflurane麻醉及甲狀腺切除術後預防噁心及嘔吐的效果

李毅(Yi Lee) ； 林佩金(Pei-Chin Lin) ； 賴賢勇(Hsien-Yong Lai) ； 黃顯哲(Shen-Jer Huang) ； 林祐生(Youh-Sheng Lin) ； 鄭清榮(Ching-Rong Cheng)

《Acta Anaesthesiologica Sinica》 39卷4期 (2001/12) Pp. 151-156

https://doi.org/10.6955/AAS.200112.0151

摘要

Background: Desflurane is associated with a higher incidence of 24-h postoperative nausea and vomiting (PONV) as compared with sevoflurane or isoflurane. Dexamethasone 5 mg i.v. is suggested to be the minimum effective dose for prophylaxis ofPONV in women undergoing thyroidectomy with isoflurane anesthesia. The objective of this study was to investigate whether a 5mg dose of dexamethasone could be enough for; or a larger dose at 8 mg, could be more capable of preventing PONV in women undergoing desfiurane anesthesia for thyroidectomy.
Methods: One hundred and thirty five patients were assigned to receive one of three treatment regimens prior to induction i.e., dexamethasone 8mg i.v. (Group D8), dexamethesone 5mg i.v. (Group D5) or saline (Group S).
Results: It was demonstrated that the prophylactic administration of either dexamethasone 8mg or 5mg significantly reduced the overall incidence of PONV in patients undergoing thyroidectomy with desfiurane anesthesia P＜0.001, Group D8 vs. Group S; Group D5 vs. Group S). Howevet; patients who received dexamethasone 8mg showed a higher incidence of complete responses (no vomiting or need of rescue antiemetic medication for a 24-h postoperative period) in comparison with those receiving dexamethasone 5mg (86% vs.67%; P＜0.01).
Conclusions: The results of this study showed that in PONV prophylaxis, in female patients undergoing desflurane anesthesia for thyroidectomy, the effect of dexamethasone 8mg was superior to that of dexamethasone 5mg.

關鍵字

Dexamethasone ； Desflurane ； 噁心嘔吐 ； 甲狀腺切除術

並列摘要

Background: Desflurane is associated with a higher incidence of 24-h postoperative nausea and vomiting (PONV) as compared with sevoflurane or isoflurane. Dexamethasone 5 mg i.v. is suggested to be the minimum effective dose for prophylaxis ofPONV in women undergoing thyroidectomy with isoflurane anesthesia. The objective of this study was to investigate whether a 5mg dose of dexamethasone could be enough for; or a larger dose at 8 mg, could be more capable of preventing PONV in women undergoing desfiurane anesthesia for thyroidectomy.
Methods: One hundred and thirty five patients were assigned to receive one of three treatment regimens prior to induction i.e., dexamethasone 8mg i.v. (Group D8), dexamethesone 5mg i.v. (Group D5) or saline (Group S).
Results: It was demonstrated that the prophylactic administration of either dexamethasone 8mg or 5mg significantly reduced the overall incidence of PONV in patients undergoing thyroidectomy with desfiurane anesthesia P＜0.001, Group D8 vs. Group S; Group D5 vs. Group S). Howevet; patients who received dexamethasone 8mg showed a higher incidence of complete responses (no vomiting or need of rescue antiemetic medication for a 24-h postoperative period) in comparison with those receiving dexamethasone 5mg (86% vs.67%; P＜0.01).
Conclusions: The results of this study showed that in PONV prophylaxis, in female patients undergoing desflurane anesthesia for thyroidectomy, the effect of dexamethasone 8mg was superior to that of dexamethasone 5mg.

並列關鍵字

Dexamethasone ； Desfiurane ； Nausea and vomiting ； Thyroidectomy.