Hanife ALTUNKAYA, Yetkin ÖZER, Alper CİHAN, IŞIL ÖZKOÇAK TURAN, Cengiz Bekir DEMİREL

Tiroidektomi operasyonlarında preoperatif uygulanan deksametazonun postoperatif bulantı-kusma ve ağrıya etkisi

Çalışmada tiroidektomi yapılacak hastalarda preoperatif tek doz deksametazon kullanımının postoperatif dönemde bulantı-kusma ve ağrıya etkisinin gösterilmesi amaçlanmıştır. Randomize, çift kör ve plasebo kontrollü bu çalışmada, tiroidektomi yapılacak, ASA I-II grubunda 40 hasta çalışma kapsamına alınmıştır. Olgular rastgele iki gruba ayrılmıştır. Operasyondan 30 sn. önce Grup D (n-20) olgulara deksametazon 8 mg iv (2cc), Grup S (n=20) olgulara ise 2 cc serum fizyolojik verilmiştir. Daha sonra tüm olgularda anestezi indüksiyonu 2 mg $kg^-1$ propofol + 2 $mu$g $kg^-1$ fentanil ile yapılmış ve kas gevşemesi 0.6 mg $kg^-1$ rokuronyum ile sağlanmıştır. Anestezi idamesi tüm olgularda l MAC Sevofluran ile yapılmıştır. Tüm olgularda postoperatif O.dk, 15, 30, 45.dk ve 2 saat ara ile ağrı (VAS), bulantı-kusma (0-3), ilk analjezik gereksiniminin olduğu zaman, toplam analjezik gereksinimi, pansumana tepki, insizyonda enfeksiyon, mobilizasyon süresi ve toplam hastanede kalış süresi kaydedildi. Gruplar demografik ve hemodinamik verileri, operasyon süreleri açısından benzer dağılım göstermiştir. Deksametazon kullanılan grup D olgularda postoperatif VAS değerleri, bulantı kusma insidansı (Grup D %20, Grup S %60) ve toplam analjezik miktarı (mg) (Grup D 58.2+28, Grup S 86.0±54) anlamlı düşük bulunmuştur (p

Anahtar Kelimeler:

Deksametazon, Tiroidektomi, Ameliyat sonrası bulantı ve kusma, Ağrı, ameliyat sonrası

The effect of preoperative dexamethasone adminisration on nause-vomiting and pain in thyroidectomy

In this study; it is aimed to evaluate the effect of preoperative single dose dexamethasone on postoperative nausea, vomiting (PONV) and pain patients planned f or thyroidectomy. Forty patients, ASA I-II, scheduled for thyroidectomy were included in this randomized, double-blinded and placebo controlled study. The patients were randomly divided into two groups. A blind investigator administered dexamethasone 8 mg iv (Group D, n=20) or 2 ml saline (Group S, n=20) to the patients. Anaesthesia induction was performed with propofol 2 mg $kg^-1$ , 2 $mu$g $kg^-1$ fentanyl and rocuronium 0.6 mg $kg^-1$'. Sevoflurane IMAC was used in all patients for the maintenance of anaesthesia. Pain (VAS pain scale), PONV (0-3 scale), the time for first analgesic need, total analgesic need, reaction to dressing, infection of insicion and mobilization time were recorded at postoperative 0, IS, 30, and 45 th min and two hours intervals in first day. The postoperative VAS scores, PONV value and total analgesic need of Group D were significantly lower than Group S (p<0.05). There was no difference between the reaction to dressing and mobilization time of the groups. In conclusion preoperative dexamethasone administration less postoperative pain and PONV in thyroidectomy.

Keywords:

Dexamethasone, Thyroidectomy, Postoperative Nausea and Vomiting, Pain, Postoperative,

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