局部应用甘草预防成人术后咽喉痛：系统评价和荟萃分析。

Topical application of licorice for prevention of postoperative sore throat in adults: A systematic review and meta-analysis.

机构信息

Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki, Okayama 710-8602, Japan.

Department of Emergency Medicine, Obamar Municipal Hospital, 2-2 Otemachi, Obama, Fukui 917-8567, Japan.

出版信息

J Clin Anesth. 2019 May;54:25-32. doi: 10.1016/j.jclinane.2018.10.025. Epub 2018 Nov 2.

DOI:10.1016/j.jclinane.2018.10.025

PMID:30391446

Abstract

STUDY OBJECTIVE

Postoperative sore throat negatively affects patient satisfaction and recovery. It may be related to inflammation of the mucosa caused by injury during intubation. Licorice, derived from the root of Glycyrrhiza glabra, contains active anti-inflammatory ingredients. The efficacy and safety of topical licorice for preventing postoperative sore throat in adults undergoing tracheal intubation for general anesthesia were assessed by a systematic review and meta-analysis.

DESIGN

A systematic review and meta-analysis of randomized controlled trials.

SETTING

Trials conducted in perioperative settings.

MEASUREMENTS

PubMed, EMBASE, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials were searched from inception to April 21, 2018. All randomized, controlled trials (RCTs) that assessed the efficacy and safety of topical licorice in adults undergoing elective surgery under general anesthesia were eligible. The risk of bias was evaluated using the Cochrane risk of bias assessment tool. Data were pooled using a random-effects model. We conducted a trial sequential analysis (TSA) on the incidence of postoperative sore throat. Primary outcomes were the incidence and severity of sore throat 24 h after surgery/extubation and adverse events.

MAIN RESULTS

Five randomized controlled trials involving 609 patients were included. Compared with non-analgesic control, topical licorice was associated with a reduced incidence (risk ratio, 0.44; 95% confidence interval (CI), 0.28-0.69; P < 0.001) and severity (standardized mean difference, -0.69; 95% CI, -0.96, -0.43; P < 0.001) of postoperative sore throat. Four trials reported adverse events; there were no significant adverse events related to topical licorice. The findings of sensitivity analyses excluding trials at high or unclear risk of each type of bias were consistent with these findings. TSA confirmed the evidence for postoperative sore throat was adequate.

CONCLUSIONS

Preoperative topical application of licorice appears significantly more effective than nonanalgesic methods for preventing postoperative sore throat.

摘要

研究目的

术后咽喉痛会降低患者满意度和康复速度。其可能与气管插管导致的黏膜炎症有关。甘草，来源于甘草根，含有活性抗炎成分。本系统评价和荟萃分析旨在评估全麻下气管插管成人围手术期应用局部甘草预防术后咽喉痛的疗效和安全性。

设计

系统评价和随机对照试验荟萃分析。

设置

围手术期进行的试验。

测量

从创建至 2018 年 4 月 21 日，检索 PubMed、EMBASE、Web of Science、Scopus 和 Cochrane 对照试验中心注册库。所有评估全麻下择期手术成人应用局部甘草预防术后咽喉痛的疗效和安全性的随机对照试验（RCT）均符合纳入标准。采用 Cochrane 偏倚风险评估工具评估偏倚风险。使用随机效应模型汇总数据。我们对术后咽喉痛的发生率进行了试验序贯分析（TSA）。主要结局是术后/拔管后 24 小时咽喉痛的发生率和严重程度以及不良事件。

主要结果

纳入 5 项 RCT，共 609 例患者。与非镇痛对照组相比，局部甘草可降低咽喉痛发生率（风险比，0.44；95%置信区间（CI），0.28-0.69；P<0.001）和严重程度（标准化均数差，-0.69；95%CI，-0.96，-0.43；P<0.001）。4 项试验报告了不良事件；与局部甘草相关的不良事件无统计学意义。排除各类型偏倚高风险或不确定风险试验后的敏感性分析结果与上述结果一致。TSA 证实术后咽喉痛的证据充足。