The Effect Of Using Dexamethasone At Different Times During Perioperative Period On Complications After Thyroidectomy

Objective The effect of using dexamethasone during perioperative period on complications after thyroidectomy are still questionable,and the study of comparation of effect of using dexamethasone at different times during perioperative period on complications after thyroidectomy is scare.The study aims to determine the best time to use dexamethasone to provide effective evidences for clinical therapy by comparing the effect of preoperative use of dexamethasone and intraoperative use of dexamethasone on complications after thyroidectomy.Methods The date of 123 cases of qualified patients with thyroid carcinoma was from November 2020 to December 2021 in Minda Hospital affiliated to Hubei Minzu University,according to the time of using dexamethasone,all of the patients were randomly divided into three groups,preoperative dexamethasone group,intraoperative dexamethasone group and control group,each of group had 41 patients.In preoperative dexamethasone group,8mg dexamethasone was injected intravenously thirty minutes before the induction of anesthesia,in intraoperative dexamethasone group,8mg dexamethasone was injected intravenously the moment thyroid had been exposed,control group,no dexamethasone was injected intravenously.Post-operative pain,voice quality,post-operative nausea and vomiting,blood glucose level,drainage volume,extubation time,hospitalization time,wound infection were all observed respectively after operation.Results The clinical data such as age,sex,body mass index,operation ways,operation time,tumor types did not differ significantly among the three groups of people（P>0.05）.Pain VAS score,1 hour after operation,there was no statistically significant differences among the three groups of people in pain VAS score（P>0.05）.12 hours after operation,there was statistically significant differences among the three groups of people in pain VAS score（P<0.05）,pain VAS score,A0.05）.Voice handicap index score,24,48 hours and 3 days after surgery,there was statistically significant differences among three groups of people in VHI score（P<0.05）.VHI score,A0.05）.Within 48 hours after surgery there was statistically significant differences among three groups of people in the incidence of post-operative nausea and vomiting（P<0.05）,the incidence of post-operative nausea and vomiting in group A less than that in group B and group C,the differences all had statistical significance（P<0.05）.There was no statistically significant differences between group B and group C in the incidence of post-operative nausea and vomiting（P>0.05）.Blood glucose level,before operation and 24,48 hours after operation,there was no statistically significant differences among three groups of people in the blood glucose level（P>0.05）.Drainage volume,1 day after surgery,the drainage volume in group A less than that in group C,the differences had statistical significance（P<0.05）.The drainage volume in group B less than that in group C,the differences had statistical significance（P<0.05）.There was no statistically significant differences between group A and group B in the drainage volume（P>0.05）.2 day after surgery there was no statistically significant differences among three groups of people in the drainage volume（P>0.05）.There was no statistically significant differences among three groups of people in the total drainage volume and extubation time（P>0.05）.There was no statistically significant differences among three groups of people in the total hospitalization time,postoperative hospitalization time and incidence of wound infection（P>0.05）.Conclusion Preoperative use of dexamethason can bring more benefits to patients than intraoperative use of dexamethasone in reducing the pain degree,the severity of voice quality,the incidence and the severity of nausea and vomiting after thyroidectomy.Preoperative use of dexamethason and intraoperative use of dexamethasone can both reduce the drainage volume on day 1,the effect was not different significantly on total drainage volume,extubation time and hospitalization time.It has no effect on high blood glucose adverse reaction and wound infection.