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首页> 外文期刊>Updates in Surgery >How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial
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How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial

机译：地塞米松如何影响腹腔镜尼森胃底折叠术的手术效果？一项随机双盲安慰剂对照试验

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摘要

Laparoscopic floppy Nissen fundoplication (LFNF) is an effective treatment for gastroesophageal reflux disease. The duration of convalescence, after noncomplicated LFNF, may depend on several factors of which pain, fatigue and sociocultural factors are the most important. Nausea and vomiting occur mainly on the day of operation. Glucocorticoids are well known for their analgesic, anti-inflammatory, immune-modulating and antiemetic effects. We therefore undertook the present study to investigate whether preoperative dexamethasone could improve surgical outcome in patients undergoing uncomplicated laparoscopic floppy Nissen fundoplication. From March 2005 to April 2008, 82 patients were randomized to receive dexamethasone (8 mg) intravenously, 90 min before skin incision or saline (placebo). Patients received a similar standardized anesthetic, surgical and multimodal analgesic treatment. The primary end points were pain and fatigue. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein (CRP), interleukin-6 and 1 (IL-6, IL-1), pain scores and nausea, and the number of vomiting episodes were registered. Dexamethasone significantly reduced postoperative levels of CRP (p = 0.01), IL-6 and IL-1 (p < 0.05), fatigue (p = 0.01) and overall pain during the first 24 postoperative hours (p < 0.05) and the total requirement of analgesic (ketorolac) (p < 0.05). Dexamethasone also reduced nausea and vomiting on the day of operation (p < 0.05). Preoperative dexamethasone (8 mg) reduced pain, fatigue, nausea and vomiting in patients undergoing uncomplicated LNF when compared with placebo.
机译：腹腔镜软性尼森胃底折叠术（LFNF）是治疗胃食管反流疾病的有效方法。单纯性LFNF后恢复期的持续时间可能取决于几个因素，其中疼痛，疲劳和社会文化因素最为重要。恶心和呕吐主要发生在手术当天。糖皮质激素以其止痛，抗炎，免疫调节和止吐作用而闻名。因此，我们进行了本研究，以调查术前地塞米松是否可改善接受简单腹腔镜软化Nissen胃底折叠术的患者的手术效果。从2005年3月至2008年4月，在皮肤切口或生理盐水（安慰剂）治疗90分钟之前，随机将82例患者静脉接受地塞米松（8毫克）。患者接受了类似的标准化麻醉，手术和多模式镇痛治疗。主要终点是疼痛和疲劳。术前和术后24小时内几次，我们测量了C反应蛋白（CRP），白介素6和1（IL-6，IL-1），疼痛评分和恶心，并记录了呕吐发作的次数。地塞米松可显着降低术后24小时内的CRP（p = 0.01），IL-6和IL-1（p <0.05），疲劳（p = 0.01）和总体疼痛水平（p <0.05） （酮咯酸）的镇痛效果（p <0.05）。地塞米松在手术当天还减少了恶心和呕吐（p <0.05）。与安慰剂相比，术前地塞米松（8毫克）可减轻接受简单LNF治疗的患者的疼痛，疲劳，恶心和呕吐。

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  • 来源
    《Updates in Surgery》 |2010年第1期|47-54|共8页
  • 作者

    M. Schietroma; M. Giuliani; G. Zoccali; F. Carnei; Z. Bianchi; Z. Gleni; G. Amicucci;

  • 作者单位

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

    Dipartimento di Scienze Chirurgiche Facoltà di Medicina e Chirurgia Presso Ospedale San Salvatore Università degli Studi dell’Aquila Edificio Delta 6 67100 Coppito (AQ) Italy;

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  • 正文语种 eng
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  • 关键词

    Dexamethasone; Pain; Laparoscopic Nissen fundoplication (LNF); Gastroesophageal reflux disease (GERD);

    机译：地塞米松;疼痛;腹腔镜尼森胃底折叠术（LNF）;胃食管反流病（GERD）;

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