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氯胺酮与硫酸镁雾化吸入减轻术后咽痛、声音嘶哑及咳嗽的有效性比较

Comparison of Usefulness of Ketamine and Magnesium Sulfate Nebulizations for Attenuating Postoperative Sore Throat, Hoarseness of Voice, and Cough.

作者信息

Rajan Sunil, Malayil George Jacob, Varghese Rekha, Kumar Lakshmi

机构信息

Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

出版信息

Anesth Essays Res. 2017 Apr-Jun;11(2):287-293. doi: 10.4103/0259-1162.181427.

Abstract

CONTEXT

Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation.

AIM

To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough.

SETTINGS AND DESIGN

Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study.

SUBJECTS AND METHODS

Patients in each group were nebulized with the respective study drug 15 min prior to the surgery, i.e., ketamine in Group K, magnesium sulfate 250 mg, and 500 mg in Group M1 and Group M2, respectively, and normal saline as control in Group C. A standardized anesthesia protocol was followed for all patients. After extubation, the patients were asked to grade POST, hoarseness, and cough at 0, 2, 4, 12, and 24 h.

STATISTICAL ANALYSIS USED

One-way analysis of variance, Chi-square test, Fisher's exact test, paired -tests, and Wilcoxon's signed-rank test as applicable.

RESULTS

Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0, 2, and 4 h, and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat, hoarseness, and cough at all periods in the study groups as compared with control.

CONCLUSION

Nebulization with ketamine 50 mg and magnesium sulfate 500 mg, 15 min before induction of general anesthesia and intubation, reduce the incidence and severity of POST and hoarseness of voice.

摘要

背景

术后咽痛(POST)是气管插管患者中尚未解决的一种并发症。

目的

比较两种浓度的氯胺酮和硫酸镁雾化吸入对POST的发生率和严重程度、声音嘶哑及咳嗽的影响。

设置与设计

本前瞻性、随机、双盲研究纳入了60例接受硬膜外和全身联合麻醉的择期腹部及下肢手术的外科患者。

对象与方法

每组患者在手术前15分钟用各自的研究药物进行雾化吸入,即K组用氯胺酮,M1组和M2组分别用250mg和500mg硫酸镁,C组用生理盐水作为对照。所有患者均遵循标准化麻醉方案。拔管后,要求患者在0、2、4、12和24小时对POST、声音嘶哑和咳嗽进行评分。

所用统计分析方法

适用时采用单因素方差分析、卡方检验、Fisher精确检验、配对t检验和Wilcoxon符号秩检验。

结果

氯胺酮和500mg硫酸镁在0、2和4小时时POST有统计学显著降低,在0小时时术后声音嘶哑有统计学显著降低。与对照组相比,研究组在所有时间段咽痛、声音嘶哑和咳嗽的发生率及严重程度均有所降低。

结论

在全身麻醉诱导和插管前15分钟雾化吸入50mg氯胺酮和500mg硫酸镁,可降低POST的发生率和严重程度以及声音嘶哑的程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d209/5490122/4fb64eadbcc8/AER-11-287-g005.jpg

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