تأثیر پروفیلاکتیک دگزامتازون تزریقی، غرغره‌ی کتامین و ترکیب دگزامتازون تزریقی و غرغره‌ی کتامین بر گلو درد و خشونت صدا بعد از خارج کردن لوله‌ی تراشه

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه بیهوشی و مراقبت‌های ویژه، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 کاردان، گروه هوشبری، مرکز پزشکی آیت‌اله ‌کاشانی، اصفهان، اصفهان، ایران

4 کارشناس، گروه پرستاری، مرکز پزشکی آیت‌اله کاشانی، اصفهان، اصفهان، ایران

چکیده

مقدمه: گلو درد و خشونت صدا بعد از لوله‌گذاری داخل تراشه جهت بیهوشی عمومی، از شکایات شایع بیماران است. مطالعه‌ی حاضر برای بررسی اثر غرغره‌ی کتامین به همراه تزریق دگزامتازون در کاهش گلو درد و خشونت صدا بعد از عمل جراحی انجام شد.روش‌ها: این کارآزمایی بالینی دو سو کور بر روی 140 بیمار 65-18 سال با  وضعیت فیزیکی 1 و 2 طبق تقسیم‌بندی انجمن متخصصین بیهوشی آمریکا که تحت عمل جراحی الکتیو با بیهوشی عمومی قرار گرفتند، انجام شد. بیماران به صورت تصادفی به 4 گروه مساوی تقسیم شدند. قبل از القای بیهوشی، گروه K 40 میلی‌گرم کتامین محلول در 30 میلی‌لیتر سالین غرغره کردند، گروه D 2/0 میلی‌گرم به ازای هر کیلوگرم وزن بدن دگزامتازون وریدی دریافت نمودند، گروه KD غرغره‌ی کتامین و دگزامتازون وریدی دریافت نمودند. به گروه شاهد (P) نرمال سالین به صورت تزریقی و غرغره داده شد. گلو درد و خشونت صدا، در زمان‌های صفر، 2، 4، 8، 16، 24 ساعت پس از عمل جراحی اندازه‌گیری شد.یافته‌ها: بروز و شدت گلو درد و خشونت صدا در تمام زمان‌ها بعد از عمل تا 24 ساعت در گروه KD نسبت به گروه P کمتر بود. همچنین گلو درد در گروه KD نسبت به هر یک از گروه‌های K و D کمتر بود (05/0 > P).نتیجه‌گیری: استفاده‌ی پروفیلاکتیک از 2/0 میلی‌گرم بر کیلوگرم دگزامتازون وریدی به همراه غرغره‌ی کتامین بروز و شدت گلو درد و خشونت صدا بعد از عمل را به طور معنی‌داری کاهش می‌دهد.

کلیدواژه‌ها

عنوان مقاله [English]

Intravenous Dexamethasone vs. Ketamine Gargle vs. Intravenous Dexamethasone Combined with Ketamine Gargle for Evaluation of Post-Operative Sore Throat and Hoarseness: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial

نویسندگان [English]

  • Sayed Mohammadreza Safavi 1
  • Azim Honarmand 1
  • Arghavan Fariborzifar 2
  • Shahnaz Barvarz 3
  • Mahnaz Soleimani 4
1 Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Anesthesia, Ayatollah Kashani Hospital, Isfahan, Iran
4 Department of Nursing, Ayatollah Kashani Hospital, Isfahan, Iran
چکیده [English]

Background: Sore throat and hoarseness are the most frequent subjective complaints after tracheal intubation for general anesthesia. We conducted a prospective, randomized, double-blind, placebo controlled study to evaluate the efficacy of intravenous dexamethasone plus ketamine gargle for reducing the incidence and severity of post-operative sore throat (POST) and hoarseness.Methods: 140 patients (aged 16-65 years) scheduled for elective surgery were enrolled. Patients were randomly allocated into four groups of 35 subjects: group K gargled 40 mg ketamine in 30 ml saline; group D were infused 0.2 mg/kg intravenous (IV) dexamethasone; group KD gargled 40 mg ketamine in 30 ml saline plus 0.2 mg/kg intravenous dexamethasone; and group P (placebo) received saline (gargle and IV). POST was graded at 0, 2, 4, 8, 16 and 24 hours after operation on a four-point scale (0–3).Findings: The incidence and severity of POST were significantly lower in group KD, compared with the other groups at all times after tracheal extubation for up to 24 hours (P < 0.05). Also, the incidence and severity of hoarseness were significantly lower in groups of KD, K and D compared with group P (P < 0.05).Conclusion: The prophylactic use of 0.2 mg/kg of intravenous dexamethasone plus ketamine gargle significantly reduced the incidence and severity of POST compared with using each of these drugs alone or using placebo.

کلیدواژه‌ها [English]

  • Ketamine
  • Dexamethasone
  • Gargle
  • Sore throat
  • Hoarseness
  • Tracheal intubation

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مجله دانشکده پزشکی اصفهان
دوره 31، شماره 242 - شماره پیاپی 242
مرداد و شهریور 1392
صفحه 933-943

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  • تاریخ دریافت: 29 فروردین 1392
  • تاریخ بازنگری: 31 فروردین 1403
  • تاریخ پذیرش: 17 فروردین 1401

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