Dexamethazone Prophylaxis before Near Total Thyroidectomy to Reduce Vocal Dysfunction: A Randomized Clinical Trial

Background: Thyroidectomy operation is one of the most common operations around the world. There are different complications of thyroidectomy including vocal cords dysfunction, hypocalcaemia, pain, bleeding, hematoma, nausea and vomiting. Objective: This study aimed to study the prophylactic effect of dexamethasone 8 mg/2ml amp, intravenous before near total thyroidectomy to reduce vocal dysfunction. Also, to study the effect in relation to pain, nausea, vomiting and hypocalcaemia. Patients and Methods: This study was conducted in Mansoura University Hospitals, Endocrine Surgery Unit during the period between July 2018 and June 2019. All patients were admitted from the Outpatient Clinic. All patients were informed about the surgical procedure in the clinic and a written consent was taken from all patients participating in the study. Sample size was calculated using G- Power with effect size 0.8 and power of 0.8 where it was 100 patients (50 patients in each group). Results: comparing the 2 groups postoperatively, the dexamethasone group had fewer complications as regards postoperative nausea, vomiting, pain, hypocalcaemia and vocal dysfunction. Conclusion: From this study, it was shown that dexamethasone 8 mg/2ml IV before near total thyroidectomy has significant effect regarding reduction of postoperative nausea, pain, vomiting, hypocalcaemia and vocal cords mobility, which was less affected. In addition, there was no side effects of dexamethasone administration. Therefore, we advise to give dexamethasone to all patients before thyroid surgery.