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Wound Drains after Thyroid- and Parathyroid Surgery Impact on Postoperative Nausea and Vomiting (PONV)
Postoperative nausea and vomiting (PONV) is common after thyroid surgery. Many patients describe PONV as more irritant in the postoperative course than the endured pain. Postoperative drains are put after thyroid surgery to early recognize bleeding and to collect wound secretion to avoid pressure on the trachea. Whether wound drains do impact on PONV is not known. Therefore, we tested the impact of wound drains on PONV after thyroid- and parathyroid surgery in a randomized controlled clinical trial.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Drain placement (Group A) | Active Comparator | Patients in group A received a wound drain after surgery. |
|
| No-drain placement (group B) | Sham Comparator | Patients assigned to group B, did not receive a wound drain after surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placement of a wound drain post surgery (Redon; Medicoplast) | Device | The wound drain, type Redon Drainage 3.0 mm in diameter |
|
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of post-operative nausea using visual analogue scale (VAS) | The development of postoperative nausea was determined using a standard visual analogue scale (VAS) with range of 0 to 10. 0 indicated no nausea, 10 indicated very severe nausea. The patients indicated their felt degree of nausea a number between 0 to 10. | 24 hours post surgery |
| Assessment of postoperative vomiting using visual analogue scale (VAS) | The development of postoperative vomiting was determined using a standard Visual analogue scale (VAS) with range of 0 to 10. 0 indicated no nausea, 10 indicated very severe nausea. The patients indicated their felt degree of vomiting indicating a number between 0 to 10. The number of vomiting was counted within the first 48h post surgery | 24 hours post surgery |
| Assessment of post-operative nausea using visual analogue scale (VAS) | The development of postoperative nausea was determined using a standard visual analogue scale (VAS) with range of 0 to 10. 0 indicated no nausea, 10 indicated very severe nausea. The patients indicated their felt degree of nausea a number between 0 to 10. | 48 hours post surgery |
| Assessment of postoperative vomiting using visual analogue scale (VAS) | The development of postoperative vomiting was determined using a standard Visual analogue scale (VAS) with range of 0 to 10. 0 indicated no nausea, 10 indicated very severe nausea. The patients indicated their felt degree of vomiting indicating a number between 0 to 10. The number of vomiting was counted within the first 48h post surgery | 48 hours post surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Antiemetic therapy post surgery in patients with and without postoperative drainage | In the postoperative course, we counted the amount of anti-emetic interventions for patients post surgery over the first 48 hours. The givage of anti-emetic drugs was based on a prior determined protocol, that was strictly followed. The protocol was as follows for antiemetic drugs: First line Drug: Tropisetron 2 mg i.v. when patient is vomiting, max. twice a day. Second line therapy: Haloperidol 0.5 mg i.v. with a maximum of 3 mg every 24 hours, when first line therapy is not sufficient. The change to second line therapy is controlled by the study physician. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christoph A Maurer, MD | Professor of Surgery, Head of the Department, Kantonsspital Liestal | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kantonsspital Liestal | Liestal | Basel-Landschaft | 4410 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9082107 | Background | Schwarz W, Willy C, Ndjee C. [Gravity or suction drainage in thyroid surgery? Control of efficacy with ultrasound determination of residual hematoma]. Langenbecks Arch Chir. 1996;381(6):337-42. doi: 10.1007/BF00191314. German. | |
| 31243574 | Derived | Kunzli BM, Walensi M, Wilimsky J, Bucher C, Buhrer T, Kull C, Zuse A, Maurer CA. Impact of drains on nausea and vomiting after thyroid and parathyroid surgery: a randomized controlled trial. Langenbecks Arch Surg. 2019 Sep;404(6):693-701. doi: 10.1007/s00423-019-01799-6. Epub 2019 Jun 26. |
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| ID | Term |
|---|---|
| D020250 | Postoperative Nausea and Vomiting |
| D013959 | Thyroid Diseases |
| D009325 | Nausea |
| D014839 | Vomiting |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012817 | Signs and Symptoms, Digestive |
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| No-drain after surgery | Other | After surgery, no drain was put |
|
| after 48 hours |
| D012816 | Signs and Symptoms |
| D004700 | Endocrine System Diseases |