The Beneficial Effect of Triamcinolone Acetonide on Nerve Repair with Autogenous Grafts

Lipton, Richard M.; McCaffrey, Thomas V.; Ellis, John

doi:10.1177/019459988609400309

Cited by 12 publications

(10 citation statements)

References 13 publications

(3 reference statements)

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“…12 There are both experimental and clinical data supporting the notion that the steroid administration may prevent or reduce neural edema. [13][14][15] Patients with idiopathic facial palsy have shown improved facial nerve function after an empirical course of corticosteroids. 16,17 Several randomized clinical trials in many different major and minor surgical procedures have been conducted to examine the effects of a perioperative single-dose glucocorticoid administration on surgical outcome.…”

Section: Otal Thyroidectomy Ormentioning

confidence: 99%

Dexamethasone for the Prevention of Recurrent Laryngeal Nerve Palsy and Other Complications After Thyroid Surgery

Schietroma¹,

Cecilia²,

Carlei³

et al. 2013

JAMA Otolaryngol Head Neck Surg

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Importance: Recurrent laryngeal nerve dysfunction and hypoparathyroidism are well-recognized, important complications of thyroid surgery. The duration of convalescence after noncomplicated thyroid operation may depend on several factors, of which pain and fatigue are the most important. Nausea and vomiting occur mainly on the day of operation. Glucocorticoids are well known for their analgesic, anti-inflammatory, immunemodulating and antiemetic effects. However, there is little information in the literature on the use of steroids in thyroid surgery, and the information that is available is conflicting.Objective: To investigate whether preoperative dexamethasone could improve surgical outcome in patients undergoing thyroid surgery.Design: A randomized double-blind placebocontrolled trial. A 30-day follow-up for morbidity was performed in all cases.Setting: All patients were hospitalized in a public hospital.Participants: From June 2008 through August 2011, 328 patients were randomized to receive either intravenous dexamethasone, 8 mg, administered 90 minutes before skin incision, or saline solution (placebo).Interventions: Intravenous dexamethasone, 8 mg. Main Outcomes and Measures:The primary end points were temporary or permanent recurrent laryngeal nerve palsy. Transient and definitive hypoparathyroidism, pain and fatigue scores, nausea, and the number of vomiting episodes were also registered. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein, interleukin 6, and interleukin 1␤ levels.Results: In the dexamethasone group, the rate of temporary recurrent laryngeal nerve palsy (4.9%) was significantly lower compared with the placebo group (8.4%) (P=.04). Also, postoperative transient biochemical hypoparathyroidism occurred more frequently in the placebo group (37.0%) than in the dexamethasone group (12.8%). Dexamethasone use significantly reduced postoperative levels of C-reactive protein (P =.01) and interleukin 6 and interleukin 1␤ (P=.02), fatigue (P=.01), and overall pain during the first 24 postoperative hours (P = .04), as well as the total analgesic (ketorolac tromethamine) requirement (P=.04). Dexamethasone use also reduced nausea and vomiting on the day of operation (P =.045). Conclusions and Relevance:Preoperative administration of dexamethasone, 8 mg, reduced postoperative temporary recurrent laryngeal nerve palsy and hypoparathyroidism rates and reduced pain, fatigue, nausea, and vomiting after thyroid surgery. However, these data require further analysis in randomized prospective studies.Trial Registration: clinicaltrials.gov Identifier: NCT01690806 Otolaryngol Head Neck Surg. 2013;139(5):471-478 T OTAL THYROIDECTOMY OR thyroid lobectomy has been accepted as the current surgical therapy for benign and malignant thyroidal disorders, 1-5 but extensive resection might increase the risk of postoperative complications. JAMA6,7 Recurrent laryngeal nerve (RLN) dysfunction and hypoparathyroidism are well-recognized, important complications of thyro...

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Section: Otal Thyroidectomy Ormentioning

confidence: 99%

Dexamethasone for the Prevention of Recurrent Laryngeal Nerve Palsy and Other Complications After Thyroid Surgery

Schietroma¹,

Cecilia²,

Carlei³

et al. 2013

JAMA Otolaryngol Head Neck Surg

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“…Várias são as substâncias potencializadoras da regeneração neural e, muitas delas, já usadas em testes clínicos (Levi-Montalcini et al, 1953;Stelmack et al, 1977;Strand et al, 1980;Levi-Montalcini, 1982;Sparrow et al 1982;Hurst et al, 1984;Leeden, 1984;Danielsen et al, 1986;Edwards et al, 1986;Lipton et al, 1986;Badalamente et al, 1987;Bansberg et al, 1987;Mengs et al, 1987;Kaupilla et al, 1988;Zinder, 1988;Badalamente et al, 1989;Chen et al, 1989;Cuello et al, 1989;Kujawa et al, 1989;Klein et al, 1989;Lipton, 1989;Snider et al, 1989;Santos et al, 1991;Lainetti et al, 1993;Costa et al, 1997;Costa et al, 2006).…”

Section: Discussionunclassified

“…Dentre os fármacos mais conhecidos podemos citar: poliaminas e aminoguanidinas (Kaupilla et al, 1988;Gilad et al, 1996), ativadores da adenilciclase (Klein et al, 1989;Urbina et al, 1996;Walikonis et al, 1998), fator de crescimento neural (Levi-Montalcini et al, 1953;Levi-Montalcini,1982;Lipton, 1989;Snider et al, 1989;Chen et al, 1989;Santos et al, 1991;Jubran et al, 2003), triancinolonas (Lipton et al, 1986;Bansberg et al, 1987) , alfa-MSH (Edwards et al, 1986), ACTH (Strand et al, 1980), leupeptina (Hurst et al, 1984;Badalamente et al, 1987;Badalamente et al, 1989;), apoliproteínas (Badalamente et al, 1987), T3 (Stelmack et al, 1977), T4 (Danielsen et al, 1986), testosterona (Kujawa et al, 1989), gangliosídeos (Sparrow et al. 1982;Leeden, 1984;Mengs et al, 1987;Cuello et al, 1989;Laineti et al, 1993) e imunossupressores (Gold, 1997;Costa e al., 2006).…”

Section: Introductionmentioning

confidence: 99%

Emprego de veias preservadas em glicerol como substituto de enxerto de nervo: estudo experimental em ratos

Cunha¹

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Section: Os Animais Dosunclassified

“…Dentre os fármacos mais conhecidos podemos citar: poliaminas e aminoguanidinas (Kaupilla et al, 1988;Gilad et al, 1996), ativadores da adenil-ciclase (Klein et al, 1989;Urbina et al, 1996;Walikonis et al, 1998), fator de crescimento neural (Levi-Montalcini et al, 1953;Levi-Montalcini,1982;Lipton, 1989;Snider et al, 1989;Chen et al, 1989;Santos et al, 1991;Jubran et al, 2003), triancinolonas (Lipton et al, 1986;Bansberg et al, 1987) , alfa-MSH (Edwards et al, 1986), ACTH (Strand et al, 1980), leupeptina (Hurst et al, 1984;Badalamente et al, 1987;Badalamente et al, 1989;), apoliproteínas (Badalamente et al, 1987), T3 (Stelmack et al, 1977), T4 (Danielsen et al, 1986), testosterona (Kujawa et al, 1989, gangliosídeos (Sparrow et al. 1982;Leeden, 1984;Mengs et al, 1987;Cuello et al, 1989;Laineti et al, 1993) e imunossupressores (Gold, 1997;Costa e al., 2006 (Ferreira et al, 1974;Ehrart et al, 1975;Ferreira et al, 1975;Zumiotti et al, 1988;Mattar et al, 1990;Costa, 1998;Costa, 2001 (Ferreira et al, 1985), de paralisias dos membros superiores e inferiores (Ferreira et al, 1974;…”

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Reconstrução de defeito de nervo fibular em ratos com veia glicerolada: análise histológica e funcional

Cunha¹

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pela amizade desde meus dias de faculdade, residência e pós-graduação. Aos meus irmãos, Regina e Sílvio, pelo apoio, amor, amizade e convívio durante toda a minha vida. A João Fábio e Brigite, pelo carinho e por estarem sempre presentes em minha vida no convívio familiar. À minha sogra D. Otacília Vidal, pelo exemplo de humildade e perseverança. A Agner, Jéfferson, Luciana, Roberta, Rodolfo e Marlon, pelo convívio, auxílio, amizade e bons momentos de confraternização. À Marília e Rômulo Terra, pela amizade e apoio em todas situações. À Daniela Renata Crippa pela amizade e convívio nestes últimos anos. Ao Prof. Ciro Ferreira Da-Silva, pelo ensino e incentivo e determinação desde o terceiro ano da faculdade. Por ser um exemplo de pesquisador e professor, tornando-se participante e pessoa fundamental para a realização desta pesquisa. Ao meu colega e amigo Dr. Roberto Albuquerque Ribeiro, que aprendi a admirar e confiar. Agradeço seus conselhos, apoio e incentivo. Ao Dr. Paulo Tuma Jr., pelo exemplo de ética profissional, pelo convívio e conselhos em minha formação de cirurgião plástico. Ao Dr. José Carlos Marques de Faria, que sempre tive como exemplo de cirurgião plástico. Ao Dr. Edgard Cardenas pelo convívio dos últimos anos e sua amizade. Ao Dr. Amir Salomão Gebrin, pela amizade e convívio. Pelas pesquisas realizadas anteriormente que foram base de nosso conhecimento. Aos assistentes da Disciplina de Cirurgia Plástica da Faculdade de Medicina da Universidade de São Paulo, pelos momentos compartilhados e pelos ensinamentos, importantes na minha formação de cirurgião plástico. À Eliane Gazetto da Pós-Graduação da Clínica Cirúrgica pelo auxílio durante o período da pós-graduação. Ao Sr. Fábio Tadeu Montesano, pela realização da estatística deste trabalho através da empresa Domus Numeri. Ao Sr. Márcio Xavier Nascimento, pelas figuras e desenhos deste trabalho através da empresa 3 em 1 Design. À Sra. Fernanda Rizzo Sanchez, pela revisão desta tese. EPÍGRAFE o homem que adquire ente (Provérbios 3:13) Esta tese está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee

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The Beneficial Effect of Triamcinolone Acetonide on Nerve Repair with Autogenous Grafts

Cited by 12 publications

References 13 publications

Dexamethasone for the Prevention of Recurrent Laryngeal Nerve Palsy and Other Complications After Thyroid Surgery

Dexamethasone for the Prevention of Recurrent Laryngeal Nerve Palsy and Other Complications After Thyroid Surgery

Emprego de veias preservadas em glicerol como substituto de enxerto de nervo: estudo experimental em ratos

Reconstrução de defeito de nervo fibular em ratos com veia glicerolada: análise histológica e funcional

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