Effect of dexamethasone mixed with ropivacaine for cervical nerve pathway blockade on postoperative swallowing function in patients undergoing thyroid surgery
10.3760/cma.j.cn131073.20231228.00604
- VernacularTitle:地塞米松混合罗哌卡因用于颈神经通路阻滞对甲状腺手术患者术后吞咽功能的影响
- Author:
Long QIAN
1
;
Weikang SHUI
;
Wenwen MA
;
Qinge WANG
;
Shanshan ZHU
Author Information
1. 徐州医科大学麻醉学院，徐州 221000
- Keywords:
Dexamethasone;
Ropivacaine;
Nerve block;
Thyroidectomy;
Deglutition disorders;
Cervical nerve
- From:
Chinese Journal of Anesthesiology
2024;44(6):666-670
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of dexamethasone mixed with ropivacaine for cervical nerve pathway blockade on the postoperative swallowing function in patients undergoing thyroid surgery.Methods:This was a prospective randomized controlled trial. One hundred twenty-four patients, regardless of gender, aged 18-60 yr, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, who underwent elective thyroidectomy at Xuzhou Cancer Hospital from March to December 2023, were selected and divided into test group (DR group, n=62) and control group (R group, n=62)using a random number table method. After induction of total intravenous anesthesia, bilateral cervical nerve pathway blockade was performed, dexamethasone 5 mg and 0.25% ropivacaine 10 ml were injected in DR group, and 0.25% ropivacaine 10 ml was injected in group R. Main outcome measures: The swallowing function was assessed using Standard Swallowing Assessment scale at 1 and 6 days postoperatively, and the occurrence of swallowing dysfunction (abnormal in any indicator) was recorded. Secondary outcome measures: numerical rating scale scores were recorded immediately after tracheal extubation and at 4, 8, 12, 24 and 48 h after tracheal extubation in both static and swallowing states. Voice function was evaluated using the Voice Handicap Index-10 at 1 and 6 days postoperatively. The use of ketorolac tromethamine and occurrence of adverse reactions after surgery were recorded. Results:Sixty-one patients were finally included in DR group and 60 patients in R group. Compared with R group, the Standard Swallowing Assessment scale scores at 1 and 6 days after operation and incidence of swallowing disorders at 1 day after operation were significantly decreased, the numerical rating scale scores at 8 and 12 h after tracheal extubation in the static state and at 4-24 h after tracheal extubation in the swallowing state were decreased, the incidence of postoperative nausea and vomiting and Voice Handicap Index-10 scores at 1 day after operation were decreased, and the number of patients who used ketorolac tromethamine was reduced in DR group ( P<0.05). Conclusions:Dexamethasone mixed with ropivacaine for cervical nerve pathway blockade can improve the postoperative swallowing function in patients undergoing thyroid surgery.
