Loick H M, Höing R, Anger C, Brodner G, Theissen J L
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1992 May;27(3):156-9. doi: 10.1055/s-2007-1000271.
Intravenous glucocorticoids before direct laryngoscopy? The necessity of a preventive injection of corticoids before direct laryngoscopy was determined in a prospective, double blind study. 51 patients, who underwent direct laryngoscopy under general anaesthesia, received either 250 mg methylprednisolone in 10 ml NaCl 0.9% (corticoid group) or 10 ml NaCl (NaCl group) intravenously one hour before laryngoscopy. Oedema formation and the degree of inflammation in the pharynx and hypopharynx were examined on the day prior to surgery and three to four hours postoperatively. Complications of the airways were noted in the immediate postoperative phase and at the time of the second examination. Direct laryngoscopy did not induce any significant change in oedema formation or degree of inflammation in both groups. However, there was a correlation between the duration of surgery and the degree of increase in oedema and inflammation in the NaCl group but not in the corticoid group. No difference between the groups was noted with regard to postoperative complications of the airways. Based on the present study, routine application of corticoids to prevent oedema after direct laryngoscopy cannot be recommended.
直接喉镜检查前静脉注射糖皮质激素?在一项前瞻性双盲研究中确定了直接喉镜检查前预防性注射皮质激素的必要性。51例在全身麻醉下接受直接喉镜检查的患者,在喉镜检查前1小时静脉注射10 ml 0.9%氯化钠溶液中含250 mg甲泼尼龙(皮质激素组)或10 ml氯化钠溶液(氯化钠组)。在手术前一天以及术后三到四小时检查咽部和下咽的水肿形成情况以及炎症程度。在术后即刻和第二次检查时记录气道并发症。两组中直接喉镜检查均未引起水肿形成或炎症程度的任何显著变化。然而,氯化钠组手术时间与水肿和炎症增加程度之间存在相关性,而皮质激素组则不存在。两组在气道术后并发症方面未观察到差异。基于本研究,不推荐常规应用皮质激素预防直接喉镜检查后的水肿。