Effects of ramosetron and dexamethasone on postoperative nausea, vomiting, pain, and shivering in female patients undergoing thyroid surgery
Effects of ramosetron and dexamethasone on postoperative nausea, vomiting, pain, and shivering in female patients undergoing thyroid surgery
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DOI：
10.1007/s00540-012-1473-8
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发表时间：
2013-02-01
影响因子：
2.8
通讯作者：
Lee, Cheol
中科院分区：
文献类型：
--
作者：
Song, Yoon-Kang;Lee, Cheol
一些止吐药在治疗术后疼痛和寒战以及术后恶心和呕吐（PONV）方面有效。本研究的目的是调查雷莫司琼和地塞米松对PONV、疼痛和寒战的影响，并确定恶心、疼痛和寒战之间的相关性。在本研究中，123名计划进行甲状腺手术的患者被随机分配到三组之一：对照组（C组，n = 41）、地塞米松组（D组，n = 41）和雷莫司琼组（R组，n = 41）。麻醉后立即静脉注射0.9%NaCl 2 mL、5 mg/mL地塞米松2 mL或0.15mg/mL雷莫司琼2 mL，R组术后恶心的发生率、严重程度和止吐药用量均显著低于D组，R组和D组均显著低于C组。C组与R组或D组之间寒战的发生率和严重程度、疼痛严重程度和镇痛剂用量存在显著差异，但R组和D组之间寒战的发生率、疼痛严重程度和镇痛剂用量无差异。寒战程度R组明显低于D组。寒战与疼痛、寒战与恶心、疼痛与恶心的相关系数分别为0.210（P = 0.010），0.106（P = 0.198）和0.190两种止吐药雷莫司琼和地塞米松，显著降低了术后恶心的发生率和严重程度，以及对急救止吐药物的需求。此外，这两种药物都有效地降低了疼痛和颤抖的严重程度。雷莫司琼在减少恶心、止吐药用量和恶心严重程度方面上级地塞米松，但在减少寒战发生率方面并不优于地塞米松。需要进一步的研究来阐明术后恶心、疼痛和寒战之间的相关性，因为本研究显示了统计学显著但较弱的相关性。
Some antiemetics are effective in the treatment of postoperative pain and shivering, as well as for postoperative nausea and vomiting (PONV). The aim of this study was to investigate the effects of ramosetron and dexamethasone on PONV, pain, and shivering and to determine the correlations between nausea, pain, and shivering.For this study, 123 patients scheduled for thyroid surgery were randomly allocated to one of three groups: the control group (group C, n = 41), dexamethasone group (group D, n = 41), or the ramosetron group (group R, n = 41). The patients were treated intravenously with 2 mL of 0.9 % NaCl, 2 mL of 5 mg/mL dexamethasone, or 2 mL of 0.15 mg/mL ramosetron immediately after anesthesia.The overall incidence and severity of postoperative nausea and the level of antiemetic consumption were significantly lower in group R compared with group D, and these parameters were significantly lower in groups R and D than in group C. There were significant differences in the incidence and severity of shivering, severity of pain, and analgesic consumption between group C and group R or D, but the incidence of shivering, pain severity, and analgesic consumption did not differ between groups R and D. The severity of shivering was significantly lower in group R than in group D. The correlation coefficients for shivering and pain, shivering and nausea, and pain and nausea were 0.210 (P = 0.010), 0.106 (P = 0.198), and 0.190 (P = 0.035), respectively, in group C.Two antiemetic drugs, ramosetron and dexamethasone, significantly reduced the incidence and severity of postoperative nausea and the need for administration of rescue antiemetic drugs. Furthermore, both drugs effectively decreased the severity of pain and shivering. Ramosetron was superior to dexamethasone for reducing nausea, antiemetic consumption, and the severity of nausea, but not for reducing the incidence of shivering. Further studies are required to elucidate the correlations between postoperative nausea, pain, and shivering, as a statistically significant but weak correlation was shown in the present study.