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Effect Of Intravenous Lidocaine Combined With Dexamethasone On The Postoperative Analgesia And The Incidence Of Postoperative Vomiting In Pediatric After Tonsillectomy

Posted on:2024-04-04Degree:MasterType:Thesis
Country:ChinaCandidate:N MaFull Text:PDF
GTID:2544307088982649Subject:Anesthesiology
Abstract/Summary:PDF Full Text Request
Objective:The aim of this study was to investigate the effect of intravenous infusion of lidocaine combined with dexamethasone on the postoperative analgesia and the incidence of postoperative vomiting in children undergoing tonsillectomy,and to provide some clinical reference value for the management of children undergoing tonsillectomy.Methods:One hundred and twenty children aged 3 to 8 years,ASA I or II,undergoing elective tonsillectomy with or without adenoidectomy at Shengjing Hospital of China Medical University were selected.According to the random number table,the children were randomly divided into 3 groups:group L(lidocaine+dexamethasone group),group D(dexamethasone group)and group C(control group),with 40 cases in each group.Children in group L received intravenous injection of 2mg/kg 0.5%lidocaine and 0.15 mg/kg dexamethasone(maximum 8 mg)at induction of anesthesia and continuous intravenous pumping of 0.1%lidocaine 1.5 mg/kg/h during surgery until the end of surgery;children in group D received intravenous injection of 0.15 mg/kg dexamethasone(maximum 8 mg)at induction and the same amount of saline during surgery.Children in group C were induced and given the same amount of saline during surgery.The general conditions,operation time and extubation time of the three groups were recorded;the HR was recorded at three time points:before the start of induction(HR0),immediately after intubation(HR1)and immediately after extubation(HR2);the emergence agitation score(PAED score)after PACU admission was assessed and recorded;the pain score(OPS score)at 0 min(T0),5 min(T1),30 min(T2),6 h(T3)and 24 h(T4)after operation was recorded;and the number of vomiting at 24 h after operation was recorded in the three groups.Results:There was no significant difference in the general conditions and operation time among the three groups(P>0.05).The extubation time of children in group L was longer than that in groups C and D,and the difference was statistically significant(P<0.05).Children in group L had more stable hemodynamics,and HR fluctuated less compared with groups D and C,and the difference was statistically significant(P<0.05).PAED scores of the three groups:group L<group D<group C,the differences between the two groups were statistically significant(P<0.05).There was no significant difference in OPS pain scores among the three groups at 5 min and6 h after surgery(P>0.05);at 0 min after surgery,the OPS scores of group L were lower than those of groups C and D(P<0.05),and there was no significant difference between groups C and D(P>0.05);at 30 min and 24 h after surgery,the OPS scores of groups D and L were lower than those of group C,and there was no significant difference between groups D and L(P>0.05).The incidence of vomiting at 24 hours after operation in groups D and L was less than that in group C,and the difference was statistically significant(P<0.05);there was no significant difference between groups D and L(P>0.05).Conclusion:Intravenous infusion of lidocaine combined with dexamethasone did not significantly reduce the incidence of vomiting and prolong the extubation time compared with dexamethasone alone,but it could reduce postoperative agitation,reduce intraoperative hemodynamic fluctuations,and reduce immediate postoperative pain which beneficial to the stable perioperative period of children.
Keywords/Search Tags:Intravenous lidocaine, Dexamethasone, Tonsillectomy, Postoperative analgesia, Postoperative vomiting
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