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直接喉镜检查患者术后镇痛药使用的相关因素

Factors Associated With the Use of Postoperative Analgesics in Patients Undergoing Direct Microlaryngoscopy.

作者信息

Taliercio Salvatore, Sanders Brian, Achlatis Stratos, Fang Yixin, Branski Ryan, Amin Milan

机构信息

1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.

2 ENT and Allergy Associates, New York, New York, USA.

出版信息

Ann Otol Rhinol Laryngol. 2017 May;126(5):375-381. doi: 10.1177/0003489417693862. Epub 2017 Feb 1.

DOI:10.1177/0003489417693862
PMID:28397564
Abstract

OBJECTIVE

Morbidity associated with suspension laryngoscopy has been well documented. However, standard of care with regard to postoperative analgesia has not been described, and anecdotal evidence suggests wide variability with regard to postoperative narcotic and non-narcotic recommendations. We sought to quantify the postoperative course following suspension microlaryngoscopy by relating patient-based and intraoperative measures with analgesic use.

METHODS

Body mass index (BMI), Friedman tongue position (FTP), and Mallampati scores as well as laryngoscope type, number of attempts required for optimal visualization, and suspension time were documented in 50 consecutive patients undergoing routine suspension microlaryngoscopy. Postoperative symptoms and analgesic use was queried on postoperative days 1, 3, and 10.

RESULTS

In this cohort, 62.5% employed postoperative analgesia. However, only 20% required narcotics. No difference in suspension time was identified in those taking analgesics (33.0 vs 37.3 minutes, P = .44). In addition, no relationship between procedure type and the need for analgesia was noted. The majority of patients (76%) described sore throat persisting for 3 postoperative days; 36% reported sore throat persisting beyond postoperative day 3.

CONCLUSIONS

The majority of patients undergoing microlaryngoscopy reported discomfort, but symptoms were largely ameliorated with over-the-counter analgesics. Routine prescription of narcotics following routine suspension laryngoscopy may be unnecessary.

摘要

目的

与支撑喉镜检查相关的发病率已有充分记录。然而,关于术后镇痛的护理标准尚未描述,且轶事证据表明术后麻醉和非麻醉建议存在很大差异。我们试图通过将基于患者和术中的测量与镇痛药物使用相关联,来量化支撑显微喉镜检查后的术后过程。

方法

记录了50例接受常规支撑显微喉镜检查的连续患者的体重指数(BMI)、弗里德曼舌位(FTP)、马兰帕蒂评分以及喉镜类型、获得最佳视野所需的尝试次数和支撑时间。在术后第1天、第3天和第10天询问术后症状和镇痛药物使用情况。

结果

在该队列中,62.5%的患者使用了术后镇痛。然而,只有20%的患者需要使用麻醉剂。使用镇痛药物的患者与未使用镇痛药物的患者在支撑时间上没有差异(33.0分钟对37.3分钟;P = .44)。此外,未发现手术类型与镇痛需求之间存在关联。大多数患者(76%)表示术后喉咙痛持续3天;36%的患者报告喉咙痛持续至术后第3天以后。

结论

大多数接受显微喉镜检查的患者报告有不适,但症状在很大程度上可通过非处方镇痛药得到缓解。常规支撑喉镜检查后常规开具麻醉剂可能没有必要。

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