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[气管插管术后声音嘶哑和咽痛:气管导管低套囊压力的影响及套囊压力指示器的作用]

[Postoperative hoarseness and sore throat after tracheal intubation: effect of a low intracuff pressure of endotracheal tube and the usefulness of cuff pressure indicator].

作者信息

Suzuki N, Kooguchi K, Mizobe T, Hirose M, Takano Y, Tanaka Y

机构信息

Department of Anesthesiology, Kyoto Prefectural University of Medicine.

出版信息

Masui. 1999 Oct;48(10):1091-5.

Abstract

Many clinical reports have described postoperative hoarseness and sore throat after general anesthesia. In most cases, these symptoms were attributed to high pressure of the endotracheal tube cuff. The recommended cuff pressure is less than 25 mmHg, as excessive pressure produces ischemia of the tracheal mucosa. However, within the safe pressure range, postoperative hoarseness and sore throat are still often observed. In this study, one hundred and ninety patients of ASA classes I or II were allocated randomly to two groups, low cuff pressure group (< 15 mmHg) or high cuff pressure group (15-25 mmHg), using continuous monitoring with a cuff pressure gauge. We investigated the incidence of postoperative hoarseness and sore throat at 24 hours after intubation and on the seventh postoperative day. The incidence of postoperative hoarseness and sore throat was significantly decreased in the low pressure group at 24 hours after intubation as compared with the high pressure group, but there was no significant difference between the two groups on the seventh postoperative day. These results suggest that keeping the cuff pressure under 15 mmHg can prevent postoperative hoarseness or sore throat at 24 hours after intubation, and that a cuff pressure gauge is thought to be one of the indispensable monitors during anesthesia.

摘要

许多临床报告都描述了全身麻醉术后出现声音嘶哑和咽痛的情况。在大多数情况下,这些症状被归因于气管导管套囊压力过高。推荐的套囊压力应低于25 mmHg,因为压力过大会导致气管黏膜缺血。然而,在安全压力范围内,术后仍经常观察到声音嘶哑和咽痛。在本研究中,190例ASA I或II级患者被随机分为两组,即低套囊压力组(<15 mmHg)或高套囊压力组(15 - 25 mmHg),采用套囊压力计进行连续监测。我们调查了插管后24小时及术后第7天声音嘶哑和咽痛的发生率。与高压力组相比,低压力组在插管后24小时声音嘶哑和咽痛的发生率显著降低,但在术后第7天两组之间无显著差异。这些结果表明,将套囊压力保持在15 mmHg以下可预防插管后24小时出现的术后声音嘶哑或咽痛,并且套囊压力计被认为是麻醉期间必不可少的监测设备之一。

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