Comparison of Ramosetron Plus Dexamethasone with Ramosetron Alone on Postoperative Nausea, Vomiting, Shivering and Pain after Thyroid Surgery
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Postoperative nausea and vomiting (PONV), postanesthetic shivering and pain are common postoperative patient complaints that can result in adverse physical and psychological outcomes. Some antiemetics are reported to be effective in the management of postoperative pain and shivering, as well as PONV. We evaluated the efficacy of dexamethasone added to ramosetron on PONV, shivering and pain after thyroid surgery.Methods: One hundred and eight patients scheduled for thyroid surgery were randomly allocated to three different groups: the control group (group C, n = 36), the ramosetron group (group R, n = 36), or the ramosetron plus dexamethasone group (group RD, n = 36). The patients were treated intravenously with 1 and 2 ml of 0.9% NaCl (group C); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 0.9% NaCl (group R); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 5 mg/ml dexamethasone (group RD) immediately after anesthesia.Results: Incidence of nausea and the need for rescue antiemetics, verbal rating scale (VRS) 1 hour pain value, ketorolac consumption, and incidence of shivering were significantly lower in group R and group RD, than in group C (P ＜ 0.05). Moreover, these parameters were significantly lower in group RD than in group R (P ＜ 0.05). Conclusions: Combination of ramosetron and dexamethasone significantly reduced not only the incidence of nausea and need for rescue antiemetics, but also the VRS 1 hour pain value, ketorolac consumption, and the incidence of shivering compared to ramosetron alone in patients undergoing thyroid surgery. (Korean J Pain 2015; 28: 39-44)
Abstract
Background: Postoperative nausea and vomiting (PONV), postanesthetic shivering and pain are common postoperative patient complaints that can result in adverse physical and psychological outcomes. Some antiemetics are reported to be effective in the management of postoperative pain and shivering, as well as PONV. We evaluated the efficacy of dexamethasone added to ramosetron on PONV, shivering and pain after thyroid surgery.Methods: One hundred and eight patients scheduled for thyroid surgery were randomly allocated to three different groups: the control group (group C, n = 36), the ramosetron group (group R, n = 36), or the ramosetron plus dexamethasone group (group RD, n = 36). The patients were treated intravenously with 1 and 2 ml of 0.9% NaCl (group C); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 0.9% NaCl (group R); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 5 mg/ml dexamethasone (group RD) immediately after anesthesia.Results: Incidence of nausea and the need for rescue antiemetics, verbal rating scale (VRS) 1 hour pain value, ketorolac consumption, and incidence of shivering were significantly lower in group R and group RD, than in group C (P ＜ 0.05). Moreover, these parameters were significantly lower in group RD than in group R (P ＜ 0.05). Conclusions: Combination of ramosetron and dexamethasone significantly reduced not only the incidence of nausea and need for rescue antiemetics, but also the VRS 1 hour pain value, ketorolac consumption, and the incidence of shivering compared to ramosetron alone in patients undergoing thyroid surgery. (Korean J Pain 2015; 28: 39-44)
참고문헌 (30)
- Apfel CC, "A simplified risk score for predicting postoperative nausea and vomiting : conclusions from cross-validations between two centers", Anesthesiology, 91, pp.693~700 (1999)
- López-Olaondo L, "Combination of ondansetron and dexamethasone in the prophylaxis of postoperative nausea and vomiting", Br J Anaesth, 76, pp.835~840 (1996)
- Yared JP, "Dexamethasone decreases the incidence of shivering after cardiac surgery: a randomized, double-blind, placebo-controlled study", Anesth Analg 19, 87, pp.795~799 (1998)
- Eberhart LH, "Independent risk factors for postoperative shivering", Anesth Analg, 101, pp.1849~1857 (2005)
- Zwischenberger JB, "Suppression of shivering decreases oxygen consumption and improves hemodynamic stability during postoperative rewarming", Ann Thorac Surg, 43, pp.428~431 (1987)
- Macintyre PE, "Effect of meperidine on oxygen consumption, carbon dioxide production, and respiratory gas exchange in postanesthesia shivering.", Anesth Analg, 66, pp.751~755 (1987)
- Song YK, "Effects of ramosetron and dexamethasone on postoperative nausea, vomiting, pain, and shivering in female patients undergoing thyroid surgery", J Anesth, 27, pp.29~34 (2013)
- Asl ME, "Ondansetron and meperidine prevent postoperative shivering after general anesthesia", Middle East J Anaesthesiol, 21, pp.67~70 (2011)
- Iqbal A, "Prophylactic granisetron vs pethidine for the prevention of postoperative shivering : a randomized control trial", Indian J Anaesth, 53, pp.330~334 (2009)
- 양소영, "Efficacy of dexamethasone added to ramosetron for preventing postoperative nausea and vomiting in highly susceptible patients following spine surgery", Korean Journal of Anesthesiology, 62(3), pp.260~265 (2012), 대한마취통증의학회
- Feroci F, "Dexamethasone prophylaxis before thyroidectomy to reduce postoperative nausea, pain, and vocal dysfunction:a randomized clinical controlled trial", Head Neck, 33, pp.840~846 (2011)
- Jakobsson J, "Preoperative single-dose intravenous dexamethasone during ambulatory surgery : update around the benefit versus risk", Curr Opin Anaesthesiol, 23, pp.682~686 (2010)
- Jeon Y, "Comparison of ramosetron, dexamethasone, and a combination of ramosetron and dexamethasone for the prevention of postoperative nausea and vomiting in Korean women undergoing thyroidectomy:a double-blind, randomized, controlled study", Curr Ther Res Clin Exp, 71, pp.78~88 (2010)
- Jo YY, "Ramosetron, dexamethasone, and their combination for the prevention of postoperative nausea and vomiting in women undergoing laparoscopic cholecystectomy", Surg Endosc, 26, pp.2306~2311 (2012)
- Ryu JH, "Ramosetron vs. ramosetron plus dexamethasone for the prevention of postoperative nausea and vomiting (PONV)after laparoscopic cholecystectomy: prospective, randomized, and double-blind study", Int J Surg, 11, pp.183~187 (2013)
- Sanchez-Ledesma MJ, "A comparison of three antiemetic combinations for the prevention of postoperative nausea and vomiting", Anesth Analg, 95, pp.1590~1595 (2002)
- Eun Jin Kim, "Combination of Antiemetics for the Prevention of PostoperativeNausea and Vomiting in High-Risk Patients", Journal of Korean Medical Science, 22(5), pp.878~882 (2007), 대한의학회
- Heffernan AM, "Postoperative nausea and vomiting--time for balanced antiemesis?", Br J Anaesth, 85, pp.675~677 (2000)
- Habib AS, "Food and drug administration black box warning on the perioperative use of droperidol : a review of the cases", Anesth Analg, 96, pp.1377~1379 (2003)
- Powell RM, "Ondansetron given before induction of anesthesia reduces shivering after general anesthesia", Anesth Analg, 90, pp.1423~1427 (2000)
- 김민수, "Effect of ramosetron on shivering during spinal anesthesia", Korean Journal of Anesthesiology, 58(3), pp.256~259 (2010), 대한마취통증의학회
- Alfonsi P, "Postanaesthetic shivering: epidemiology, pathophysiology, and approaches to prevention and management", Drugs, 61, pp.2193~2205 (2001)
- Memiş D, "The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol, and fentanyl", Anesth Analg, 94, pp.1517~1520 (2002)
- Memiş D, "The prevention of propofol injection pain by tramadol or ondansetron", Eur J Anaesthesiol, 19, pp.47~51 (2002)
- Hval K, "The prolonged postoperative analgesic effect when dexamethasone is added to a nonsteroidal antiinflammatory drug(rofecoxib)before breast surgery", Anesth Analg, 105, pp.481~486 (2007)
- Fredrikson M, "Nausea in cancer chemotherapy is inversely related to urinary cortisol excretion", Br J Cancer, 65, pp.779~780 (1992)
- Aapro MS, "Double-blind crossover study of the antiemetic efficacy of high-dose dexamethasone versus high-dose metoclopramide", J Clin Oncol, 2, pp.466~471 (1984)
- Sapolsky RM, "How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions", Endocr Rev, 21, pp.55~89 (2000)
- Jansen NJ, "Inhibition by dexamethasone of the reperfusion phenomena in cardiopulmonary bypass", J Thorac Cardiovasc Surg, 102, pp.515~525 (1991)
- Sánchez-Rodríguez PE, "Effect of dexamethasone on postoperative symptoms in patients undergoing elective laparoscopic cholecystectomy : randomized clinical trial", World J Surg, 34, pp.895~900 (2010)