Effect Of Preoperative Injection Of Dexamethasone At Neiguan Point On Nausea,vomiting And Stress After Thyroid Surgery In Elderly Patients With Hypertension

Objective:To investigate the efficacy of injection of dexamethasone at Neiguan point before anesthesia induction on nausea,vomiting and stress after thyroid operation in elderly patients with hypertension.Methods:A total of 200 elderly hypertensive patients aged 66-90 years who underwent elective thyroid surgery and were classified by the American Society of Anesthesiologists(ASA)physical classification(Grade II-III)were divided into 2 groups(100 patients in each group)according to random number table method: Preoperative injection of dexamethasone at Neiguan points(P6D group)and preoperative intravenous injection of dexamethasone(IVD group),the dose of preoperative injection of dexamethasone was10mg(intravenous injection of 2ml: 10 mg,or bilateral injection of 1ml: 5mg at each Neiguan point).The concentrations of blood glucose(GLU),cortisol(CORT),epinephrine(E)and 5-hydroxytryptamine(5-HT)in the 2 groups were monitored before surgery,6h,12 h and 24 h after surgery,and the number of cases of nausea and vomiting in the 2groups 0-6h,6-12 h and 12-24 h after surgery and their severity scores were recorded.The degree of Recovery was assessed by 15-item Quality of Recovery(Qo R-15)24h later.The48 hours discharge rate of patients after operation was calculated.Results:Compared with IVD group,the concentrations of GLU,CORT,E and 5-HT in blood of P6 D group were significantly decreased at 3 time points after surgery(P < 0.001),the positive rate and severity of nausea and vomiting in 0-6h after surgery were significantly decreased(P < 0.05),and the scores of 15 recovery quality tables were significantly increased(P < 0.001).The discharge rate at 48 h was significantly increased(P < 0.001).Conclusion:Injection of dexamethasone at Neiguan point before anesthesia induction can significantly reduce the incidence and severity of nausea and vomiting within 0-6h after thyroid surgery in elderly patients with hypertension,significantly inhibit postoperative stress,improve the overall recovery effect,shorten the length of hospital stay in patients,and is significant for improvement of clinical practice.