Department of Anesthesiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
PLoS One. 2013 Oct 4;8(10):e74467. doi: 10.1371/journal.pone.0074467. eCollection 2013.
Recent studies showed that sore throat following endotracheal intubation was a common problem following surgery. The objective of this systematic review and meta-analysis of published randomized controlled trials (RCTs) or cohort studies was to estimate whether the size of endotracheal tube (ETT) affects the incidence of postoperative sore throat (POST) after general anesthesia.
The following databases were searched electronically: PubMed (updated to Dec 2012), EMBASE (updated to 15 Dec 2012), Google scholar, World Health Organization International Clinical Trials Registry Platform (Jul 2011), Chinese BioMedical Literature Database (1978 to Jul 2011), and China National Knowledge Infrastructure (1994 to Jul 2011). Studies comparing the size of endotracheal tube for elective surgery were included.
Three trials with a total of 509 female patients were included in the current analysis. The size of ETT used were 6.0 mm and 7.0 mm. Pooled studies from these trials showed that the smaller size of ETT (6.0 mm) significantly decreased the incidence of POST in post-anesthesia care unit (PACU) (RR = 0.56, 95% CI 0.42-0.75, P<0.01) and at 24 h after surgery (RR = 0.69, 95% CI 0.48-0.99, P<0.05). A smaller size of ETT (6.0 mm) was associated with a lower incidence of PH in PACU (RR = 0.69, 95% CI 0.55-0.87, P<0.01), but did not affect the incidence of PH at 24 h after surgery (RR = 0.73, 95% CI 0.46-1.15, P>0.05).
Our meta-analysis suggests that patients under general anesthesia with a smaller size of ETT (6.0 mm) were associated with a lower incidence of POST in female patients. More studies with adequate numbers of patients were warranted to evaluate other size of ETT on the incidence of PH and POST after general surgery among different populations.
最近的研究表明，气管插管后咽痛是手术后常见的问题。本系统评价和荟萃分析旨在评估气管内导管（ETT）的大小是否会影响全身麻醉后术后咽痛（POST）的发生率，纳入了已发表的随机对照试验（RCT）或队列研究。
电子检索以下数据库：PubMed（更新至 2012 年 12 月）、EMBASE（更新至 2012 年 12 月 15 日）、Google 学术、世界卫生组织国际临床试验注册平台（2011 年 7 月）、中国生物医学文献数据库（1978 年至 2011 年 7 月）和中国国家知识基础设施（1994 年至 2011 年 7 月）。纳入了比较择期手术中气管内导管大小的研究。
当前分析纳入了三项共 509 例女性患者的试验。使用的 ETT 尺寸为 6.0 毫米和 7.0 毫米。这些试验的汇总研究表明，较小尺寸的 ETT（6.0 毫米）可显著降低麻醉后护理单元（PACU）中 POST 的发生率（RR=0.56，95%CI 0.42-0.75，P<0.01）和术后 24 小时（RR=0.69，95%CI 0.48-0.99，P<0.05）。较小尺寸的 ETT（6.0 毫米）与 PACU 中 PH 的发生率较低相关（RR=0.69，95%CI 0.55-0.87，P<0.01），但对术后 24 小时的 PH 发生率无影响（RR=0.73，95%CI 0.46-1.15，P>0.05）。
我们的荟萃分析表明，全身麻醉下使用较小尺寸的 ETT（6.0 毫米）的患者在女性患者中 POST 的发生率较低。需要更多的研究来评估不同人群中不同 ETT 大小对 POST 和 PH 的发生率的影响。
