マルヤマ　タカシ   MARUYAMA Takashi   丸山　隆志    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The effect of single low-dose dexamethasone on vomiting during awake craniotomy
掲載誌名	正式名：Journal of Anesthesia ISSNコード：1438-8359 (Electronic)0913-8668 (Linking)
巻・号・頁	30(6),pp.941-948
著者・共著者	KAMATA Kotoe†, MORIOKA Nobutada, MARUYAMA Takashi, KOMAYAMA Noriyuki, NITTA Masayuki, MURAGAKI Yoshihiro, KAWAMATA Takakazu, Ozaki Makoto
発行年月	2016/12
概要	PURPOSE: Intraoperative vomiting leads to serious respiratory complications that could influence the surgical decision-making process for awake craniotomy. However, the use of antiemetics is still limited in Japan. The aim of this study was to investigate the effect of prophylactically administered single low-dose dexamethasone on the incidence of vomiting during awake craniotomy. The frequency of hyperglycemia was also examined. METHODS: We conducted a retrospective case review of awake craniotomy for glioma resection between 2012 and 2015. RESULTS: Of the 124 patients, 91 were included in the analysis. Dexamethasone was not used in 43 patients and the 48 remaining patients received an intravenous bolus of 4.95 mg dexamethasone at anesthetic induction. Because of stable operating conditions, no one required conscious sedation throughout functional mapping and tumor resection. Although dexamethasone pretreatment reduced the incidence of intraoperative vomiting (P = 0.027), the number of patients who complained of nausea was comparable (P = 0.969). No adverse events related to vomiting occurred intraoperatively. Baseline blood glucose concentration did not differ between each group (P = 0.143), but the samples withdrawn before emergence (P = 0.018), during the awake period (P<0.0001) and at the end of surgery (P<0.0001) showed significantly higher glucose levels in the dexamethasone group. Impaired wound healing was not observed in either group. CONCLUSION: A single low-dose of dexamethasone prevents intraoperative vomiting for awake craniotomy cases. However, as even a small dose of dexamethasone increases the risk for hyperglycemia, antiemetic prophylaxis with dexamethasone should be administered after careful consideration. Monitoring of perioperative blood glucose concentration is also necessary.
DOI	doi:10.1007/s00540-016-2243-9
文献番号	27572549
researchmap用URL	http://www.ncbi.nlm.nih.gov/pubmed/27572549