Effects Of Dexamethasone For Postoperative Variations Of The Voice And Pain In Patients Undergoing Thyroidectomy

Objective：To observe the variations of the voice and pain by a single dose ofdexamethasone before general anesthesia after the patients who undergoingthyroidectomy.Methods：One hundred and twenty patients (ASA I-II) aged thirty to seventy years oldsscheduled for thyroidectomy undergoing anesthesia in The First’s Hospital of JilinUniversity were enrolled.Exclusion criteria were:previous surgery, pathologicalfindings on laryngeal examination, preoperative or postoperative steroid therapy,diabetes mellitus, pregnancy, severe liver and kidney dysfunction, peptic ulcer. Allpatients were randomly divided into two groups: Dexamethasone group (Group D)and Control group (Group C）,60cases in each group.All surgeries were completedby total intravenous anesthesia.Before general anesthesia,the patients indexamethasone group received intravenous8mg.The patients in control groupreceived the same volume of normal saline. Induction of anesthesia was performedwith midazolam0.03mg/kg, fentanyl3ug/kg, cisatracurium0.15mg/kg, etomidate0.3mg/kg. A endotracheal tube airway was inserted and mechanical ventilation wasperformed.During maintenance of anesthesia, propofol was infused at rate of4-6mg/kg/h, remifentanyl was infused at the rate of6-8ug/kg/h.The depth of anesthesiawas monitored by narcotrend until achieved the NTS of D2-E0by adjusted thepropofol and remifentanyl infusion. The muscle relaxants was stopped injection and0.07mg/kg hydrochloride was injected at half an hour before the surgery end. Whenthe surgery ended,we pulled out of the endotracheal tube until the patients awake.Record the general situation of two groups of patients,such as gender, age, BMI,surgical time and anesthesia time. The Voice handicap index(VHI) was applied to evaluate at preoperative1d,and2,7d after operation. The VAS(visual analog scale)was applied to evaluate at1h,6h,12h,24h,48h.Results：One hundred and twenty patients were joined the study.The VHI score at1dbefore operation,1d and7d after operation among the two groups had no significantdifferences (P＞0.05).Compared with1d before operation,the VHI score at2,7d after operation wereincreased (P＜0.05).Compared with Group C, the VAS score in Group D at2h、6h、12h、24h and48hwere decreased（P＜0.05）.Conclusion:The voice of the patients undergoing thyroidectomy were obviously changedthan before. The voice of the patients undergoing thyroidectomy were not improvedwheather he or she intravenous8mg dexamethasone,but the pain were reduced thandid not use dexamethasone.