Comparison the Effects of Intravenous Hydrocortisone and Dexamethasone before Extubation on Laryngospasm, Cough and Stridor after General Anesthesia

A. Hamzei, M. Mogadam, mahmod Yousef zadeh Ghoshani, masomeh Heidary karizaki
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Abstract

Aims After tracheal extubation, following the patient’ waking up from general anesthesia, respiratory physiological responses are with symptoms such as cough, laryngospasm, and stridor. Different medications are used to prevent these complications. The aim of this study was to compare the effects of intravenous hydrocortisone and dexamethasone on the respiratory side-effects before tracheal extubation. Materials & Methods In this two-blinded clinical trial, 108 patients candidate for orthopedic surgery, general surgery, and urology by general anesthesia hospitalized in Shahid Hashemi Nezhad and Bidaxt 15th Khordad hospitals were studied in Mashhad, Iran, in 2015. The subjects were selected via available sampling method. Randomized assignment was done by BBR. The first and the second groups received 100mg hydrocortisone and 8mg dexamethasone 30 minutes before tracheal extubation as one intravenous dosing, respectively. Individual information and clinical status were recorded based on the diagnoses by an anesthesiologist. Data was analyzed by SPSS 13 software using Chi-square, independent T, and Mann-Whitney tests. Findings There was no significant difference between dexamethasone and hydrocortisone groups in the frequencies of cough, laryngospasm, and stridor (p>0.05). There were significant differences between the mean weights of patients with laryngospasm (p=0.03), cough (p=0.002), and stridor (p=0.001) and the patients without such symptoms. There was no significant difference in gender between patients with stridor and laryngospasm and other patients without such symptoms (p>0.05), excluding patients with cough (p=0.003). Conclusion The effects of hydrocortisone and dexamethasone are similar on laryngospasm, cough, and stridor after tracheal extubation.
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拔管前静脉注射氢化可的松与地塞米松对全麻后喉痉挛、咳嗽、喘鸣的影响比较
目的气管拔管后,患者全麻苏醒后,呼吸生理反应出现咳嗽、喉痉挛、喘鸣等症状。不同的药物被用来预防这些并发症。本研究的目的是比较气管拔管前静脉注射氢化可的松和地塞米松对呼吸系统副作用的影响。材料与方法本双盲临床试验选取2015年在伊朗马什哈德Shahid Hashemi Nezhad和Bidaxt第15 Khordad医院住院的108例全麻骨科、普外科和泌尿外科候诊患者为研究对象。采用现有的抽样方法选取研究对象。随机分配由BBR完成。第一组和第二组在拔管前30分钟分别给予氢化可的松100mg和地塞米松8mg,为单次静脉给药。根据麻醉医师的诊断记录患者的个人信息和临床状况。数据分析采用SPSS 13软件,采用卡方检验、独立T检验和Mann-Whitney检验。地塞米松组与氢化可的松组患者咳嗽、喉痉挛、喘鸣频次比较,差异无统计学意义(p>0.05)。有喉痉挛(p=0.03)、咳嗽(p=0.002)、喘鸣(p=0.001)患者的平均体重与无这些症状的患者有显著差异。除咳嗽患者外,有喘鸣、喉痉挛患者与无喘鸣、喉痉挛患者的性别差异无统计学意义(p>0.05)。结论氢化可的松与地塞米松对气管拔管后喉痉挛、咳嗽、喘鸣的作用相似。
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