From the *Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; †Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggido, Republic of Korea; and ‡Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Anesth Analg. 2017 Oct;125(4):1240-1245. doi: 10.1213/ANE.0000000000001933.
Although minor, a sore throat after endotracheal intubation can adversely affect patient satisfaction and postoperative function. We compared the effects of 2 endotracheal tube cuff shapes on postoperative sore throat.
One hundred ninety-one adult patients were included in the study. After induction of anesthesia, patients were randomized to endotracheal intubation with a conventional cylindrical-shaped cuff (Group C, n = 95) or a tapered-shaped cuff (Group T, n = 96). The number of intubation attempts, time to achieve endotracheal intubation, and duration of intubation were recorded. Postoperative sore throat and hoarseness were assessed at 1, 6, and 24 hours after surgery. A 0- to 100-mm visual analog scale was used to evaluate sore throat severity. The primary outcome of this study was the overall cumulative incidence of postoperative sore throat in the 24-hour evaluation period in the 2 groups.
The overall incidence of postoperative sore throat was lower in Group T than in Group C (32% vs 54%; relative risk = 0.60, 95% confidence interval: 0.43-0.85; P= .003). At 6 hours after surgery, the incidence and severity of postoperative sore throat were lower in Group T compared with Group C (Bonferroni-corrected P< .05). Postoperative hoarseness also occurred less frequently in Group T compared with Group C (19% vs 37%; P= .006). Group T had lower incidence of hoarseness at 1 and 6 hours after surgery than Group C (Bonferroni-corrected P< .05), but the incidence of hoarseness at 24 hours after surgery did not differ between groups.
Intubation using an endotracheal tube with a tapered cuff reduced the incidence and severity of postoperative sore throat and the incidence of hoarseness after surgery when compared with an endotracheal tube with a cylindrical cuff.
即使是轻微的气管插管后咽痛也会对患者满意度和术后功能产生不利影响。我们比较了两种气管导管套囊形状对术后咽痛的影响。
本研究纳入 191 例成年患者。麻醉诱导后，患者随机接受常规圆柱形套囊（C 组，n=95）或锥形套囊（T 组，n=96）气管插管。记录插管次数、达到气管插管的时间和插管持续时间。术后 1、6 和 24 小时评估术后咽痛和声音嘶哑。采用 0-100mm 视觉模拟评分法评估咽痛严重程度。本研究的主要结局是两组在 24 小时评估期内术后咽痛的总累积发生率。
T 组术后咽痛总发生率低于 C 组（32% vs 54%；相对风险=0.60，95%置信区间：0.43-0.85；P=0.003）。术后 6 小时，T 组术后咽痛的发生率和严重程度低于 C 组（Bonferroni 校正后 P<0.05）。T 组术后声音嘶哑也较 C 组少见（19% vs 37%；P=0.006）。T 组术后 1 和 6 小时声音嘶哑发生率低于 C 组（Bonferroni 校正后 P<0.05），但术后 24 小时声音嘶哑发生率两组间无差异。
与圆柱形气管导管相比，锥形气管导管套囊可降低术后咽痛和术后声音嘶哑的发生率和严重程度。
