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題名:Dexamethasone Combined with Morphine does not Decrease Postoperative Nausea and Vomiting in Patients Undergoing Thyroidectomy or Parathyroidectomy     (12點)
Dexamethasone合併Morphine使用無法減少甲狀腺或副甲狀腺手術後之噁心和嘔吐
著者:Jong-Yueh Lin(林忠岳) ;Fong-Fu Chou(周逢復) ;Ting-Lung Lin(林廷龍) ;Kun-Chou Hsieh(謝焜州) ;Ya-Ling Yang(楊雅玲)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:dexamethasone ; general anesthesia ; morphine ; postoperative nausea and vomiting
刊名:Formosan journal of surgery
卷期:43卷1期(2010.2)
頁碼:20-25
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:本篇論文的目的是針對那些接受甲狀腺或副甲狀腺手術的患者研究,若曾於麻醉結束前注射Morphine以減少術後疼痛,術前注射Dexamethasone是否依然能夠減少手術後噁心嘔吐發生的發生率。 方法:此次研究包含122位年齡介於14到79歲的患者。所有的患者隨機分?兩組:第一組(N=80)於麻醉前注射Dexamethasone,第二組(N=42)於麻醉前注射生理食鹽水。另外,在第一組中有39名患者在麻醉結束前曾注射Morphine止痛。比較在手術後4小時和24小時評估每位患者噁心的感覺、嘔吐的發生率以及其他的差異。 結果:在手術從4小時,第二組和第一組中未注射Morphine的患者做比較,噁心的感覺和嘔吐的發生率較高。第一組中未注射Morphine和注射過Morphine的患者做比較,噁心的感覺和嘔吐的發生率較高。 結論:麻醉前使用Dexamothasone可以減少手術後4小時手噁心嘔吐的發生率。但是對於那些麻醉結束前曾注射Morphine減少術後疼痛的患者,術前注射Dexamethasone無法減少手術後噁心嘔吐發生的發生率。
Objective: A prospective, randomized, double-blind study was conducted to investigate the efficacy of dexamethasone in the prevention of postoperative nausea and vomiting (PONV) in patients who underwent thyroid or parathyroid surgery, when combined with morphine injection at the end of general anesthesia. Methods: One hundred and twenty-two patients between 14 and 79 years old were included in this study. Group Ⅰ(N=80) consisted of patients who received dexamethasone (10 mg) before induction, and Group Ⅱ (N=42) consisted of those who received placebo (normal saline, 10 ml) before induction. Thirty-nine patients in group Ⅰ were given morphine (5 mg) by the anesthetists, before the end of general anesthesia. At 4 hr and 24 hr after surgery, the sensation of nausea and the incidence of vomiting were assessed. Results: At 4 hr after surgery, the sensation of nausea and incidence of vomiting were significantly higher in Group Ⅱ than in Group Ⅰ without morphine injection (P=0.009 and P=0.010, respectively) and significantly higher in patients receiving morphine than in patients without morphine of Group Ⅰ (P=0.026 and P=0.008, respectively). Conclusions: Preinduction with dexamethasone (10 mg) infusion can decrease PONV at 4 hr after surgery if morphine is not used, but dexamethasone infusion in conjunction with morphine injection before the end of general anesthesia does not decrease PONV.


    

本卷期目次
Formosan journal of surgery 43卷1期 (2010.2)
Pathophysiological Factors Contributing to Keloid Formation/ Fa-Lai Yeh
Results of Unstable Peritrochanteric Fractures Treated with Dynamic Hip Screws (DHS) Fixation with or without Trochanter Stabilizing Plate (TSP) Augmentation/ Chun-Wei YewChun-Yu ChangPo-Wen Shen
Dexamethasone Combined with Morphine does not Decrease Postoperative Nausea and Vomiting in Patients Undergoing Thyroidectomy or Parathyroidectomy/ Jong-Yueh LinFong-Fu ChouTing-Lung LinKun-Chou HsiehYa-Ling Yang
Malignant Extrarenal Rhabdoid Tumors of the Omentum with Hemoperitoneum: Report of a Case/ Hui-Han LinShih-Chi WuRay-Jade ChenYu-Chiang Lin
Stab Wound in the Neck with Injury to the Cervical Cord and Ipsilateral Vertebral Artery: Report of a Case/ Da-Wei HuangKuo-Cheng HuangVong-Kuoy PhuongShih-Hahn Chen
Umbilical Metastasis-An Unusual Presentation of Colon Cancer: Report of two Cases and Review of Literature/ Ting-Min HsiehCheuk-Kwan SunHong-Hwa Chen
Primary Intraventricular Hemorrhage due to Rupture of Angiographically Occult Vascular Malformation: Report of a Case/ Yu-Kai ChengMing-Shian LuJen-Tsung YangMing-Hsueh LeeChen-Hsing SuTing-Chung Wang
First-line Therapy with Lapatinib (TykerbR) in Metastatic Breast Cancer that Progressed on Adjuvant Trastuzumab (HerceptinR) Treatment: Report of a Case/ Ya-Fen HsuFiona Tsui-Fen ChengYen-Kung ChenChin-Chu Wu
Arterial Switch Operation for Transposition of the Great Arteries/ Ing-Sh Chiu
 
   
 
   

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