Rajan Sunil, Tosh Pulak, Paul Jerry, Kumar Lakshmi
Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Indian J Anaesth. 2018 Jan;62(1):66-71. doi: 10.4103/ija.IJA_382_17.
Post-operative sore throat (POST) is often considered an inevitable consequence of tracheal intubation. This study was performed to compare the effect of inhaled budesonide suspension, administered using a metered dose inhaler, on the incidence and severity of POST.
In this prospective randomised study, 46 patients undergoing laparoscopic surgeries lasting <2 h were randomly allotted into two equal groups. Group A received 200 μg budesonide inhalation suspension, using a metered dose inhaler, 10 min before intubation, and repeated 6 h after extubation. No such intervention was performed in Group B. The primary outcome was the incidence and severity of POST. Secondary outocomes included the incidence of post-operative hoarseness and cough. Pearson's Chi-square test, Fisher's exact test and Independent sample -test were used as applicable.
Compared to Group B, significantly fewer patients had POST in Group A at 2, 6, 12 and 24 h ( < 0.001). Although more patients in Group B had post-operative hoarseness of voice and cough at all-time points, the difference was statistically significant only at 12 h and 24 h for post-operative hoarseness and at 2 h and 12 h for post-operative cough. Severity as well as the incidence of POST showed downward trends in both groups over time, and by 24 h no patient in Group A had sore throat.
Inhaled budesonide suspension is effective in significantly reducing the incidence and severity of POST.
术后咽喉痛（POST）通常被认为是气管插管不可避免的后果。本研究旨在比较使用定量吸入器给予吸入用布地奈德混悬液对POST发生率和严重程度的影响。
在这项前瞻性随机研究中，46例接受持续时间<2小时腹腔镜手术的患者被随机分为两组，每组人数相等。A组在插管前10分钟使用定量吸入器吸入200μg布地奈德混悬液，并在拔管后6小时重复给药。B组未进行此类干预。主要结局是POST的发生率和严重程度。次要结局包括术后声音嘶哑和咳嗽的发生率。根据适用情况使用Pearson卡方检验、Fisher精确检验和独立样本t检验。
与B组相比，A组在2、6、12和24小时时发生POST的患者明显更少（<0.001）。尽管B组在所有时间点术后声音嘶哑和咳嗽的患者更多，但差异仅在术后声音嘶哑的12小时和24小时以及术后咳嗽的2小时和12小时具有统计学意义。POST的严重程度和发生率在两组中均随时间呈下降趋势，到24小时时A组无患者出现咽喉痛。
吸入用布地奈德混悬液可有效显著降低POST的发生率和严重程度。
