Honarmand Azim, Safavi Mohammadreza
Department of Anesthesiology and Critical Care Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Ann Saudi Med. 2008 Jan-Feb;28(1):11-6. doi: 10.5144/0256-4947.2008.11.
Previous reports indicate that inhaled corticosteroids attenuate airway inflammation. Beclomethasone inhaler was highly effective in the prevention of postoperative airway symptoms. Intravenous lidocaine prior to endotracheal intubation has also been shown to decrease the incidence of postoperative sore throat and cough. The aim of the present study was to compare the effect of beclomethasone inhaler with various clinically used dosages of intravenous lidocaine prior to endotracheal intubation on the incidence and severity of postoperative sore throat, cough, sputum, hoarseness, and dysphagia.
One hundred twenty patients undergoing elective operations were assigned to one of four treatments: intravenous lidocaine 1mg/kg (Group L1, n=30), intravenous lidocaine 1.5 mg/kg (Group L2, n=30), beclomethasone inhaler 50 microg (Group B, n=30) or intravenous normal saline (Group C, n=30). The incidence and severity of sore throat, cough, sputum, hoarseness, and dysphagia were compared between the beclomethasone inhaler and intravenous lidocaine groups before they left the operating room, 1 hour later, at time of the first postoperative drink or meal (for assessment of dysphagia), and on the morning after surgery.
In the evaluation of postoperative symptoms, the incidence and severity of sore throat were significantly lower in Group L2 and B than Group C (P<.05) at all time intervals. One and 20 hours after emergence from anesthesia, the incidence and severity of cough were significantly lower in Group L2 and B than Group C (P<.05). The incidence and severity of sore throat or cough was not significantly different between Groups L2 and B. Throughout the study, the incidence and severity of sputum were significantly lower in Group B than group C (P<.05).
Beclomethasone inhaler is comparable with intravenous lidocaine prior to intubation in decreasing postoperative sore throat and cough. In addition, beclomethasone inhaler decreases the incidence and severity of postoperative sputum.
既往报道表明吸入性糖皮质激素可减轻气道炎症。倍氯米松吸入器在预防术后气道症状方面非常有效。气管插管前静脉注射利多卡因也已显示可降低术后咽痛和咳嗽的发生率。本研究的目的是比较倍氯米松吸入器与气管插管前不同临床使用剂量的静脉利多卡因对术后咽痛、咳嗽、咳痰、声音嘶哑和吞咽困难的发生率及严重程度的影响。
120例行择期手术的患者被分配至四种治疗组之一：静脉注射利多卡因1mg/kg（L1组，n = 30）、静脉注射利多卡因1.5mg/kg（L2组，n = 30）、倍氯米松吸入器50μg（B组，n = 30）或静脉注射生理盐水（C组，n = 3０）。比较倍氯米松吸入器组和静脉利多卡因组在离开手术室前、1小时后、术后首次饮水或进食时（用于评估吞咽困难）以及术后次日早晨咽痛、咳嗽、咳痰、声音嘶哑和吞咽困难的发生率及严重程度。
在术后症状评估中，L2组和B组在所有时间点咽痛的发生率和严重程度均显著低于C组（P <.05）。麻醉苏醒后1小时和20小时，L2组和B组咳嗽的发生率和严重程度显著低于C组（P <.05）。L2组和B组之间咽痛或咳嗽的发生率和严重程度无显著差异。在整个研究过程中，B组咳痰的发生率和严重程度显著低于C组（P <.05）。
在降低术后咽痛和咳嗽方面，倍氯米松吸入器与插管前静脉注射利多卡因相当。此外，倍氯米松吸入器可降低术后咳痰的发生率和严重程度。
