Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Can J Anaesth. 2019 Aug;66(8):934-942. doi: 10.1007/s12630-019-01371-2. Epub 2019 Apr 16.
We compared the effects of benzydamine hydrochloride (BH), 10% lidocaine, and normal saline spray on preventing postoperative sore throat (POST) in patients who underwent total thyroidectomy (TT).
In this prospective, randomized, parallel-group, double-blind study, the incidence of POST at six hours after tracheal extubation was compared among three groups as a primary outcome. American Society of Anesthesiologists physical status I-II patients undergoing elective TT under general anesthesia were enrolled. Patients were randomly stratified into group C (n = 33, normal saline), group L (n = 33, 10% lidocaine), or group B (n = 33, 0.3% BH). The participants, caregiver, and investigator were blinded to group assignment. Each study drug was sprayed three times on the endotracheal tube (ETT) cuff ten seconds before intubation. Incidence and severity of POST were recorded within 24 hr postoperatively (during postanesthesia care unit stay, and at six, 12, and 24 hr after extubation). P values were adjusted for multiple comparisons.
Ninety-nine patients were enrolled. Eighty-seven patients completed the study. The incidence of POST at six hours after tracheal extubation was similar among the three groups (group C: 31 [93.9%], group L: 29 [87.9%], and group B: 27 [81.8%]; P = 0.38). Nevertheless, the incidence of POST was significantly different among the three groups at 12 and 24 hr after TT (12 hr: P = 0.002, 24 hr: P = 0.01). The severity of POST after tracheal extubation was statistically different among the study groups (6 hr: P = 0.04, 12 hr: P = 0.01). No adverse effects were observed.
Application of BH spray on the ETT cuff reduced the incidence and severity of POST at 12 hr after TT. We suggest this method to be a non-invasive and effective management option for POST without serious side effects.
Clinical Research Information Service (KCT0002627); registered 24 November, 2017.
我们比较了盐酸苯佐卡因(BH)、10%利多卡因和生理盐水喷雾对预防甲状腺全切除术(TT)后咽喉痛(POST)的效果。
在这项前瞻性、随机、平行组、双盲研究中,我们将三组患者在气管拔管后 6 小时时的 POST 发生率作为主要结局进行比较。纳入美国麻醉医师协会身体状况 I-II 级、全身麻醉下择期行 TT 的患者。患者被随机分为 C 组(n=33,生理盐水)、L 组(n=33,10%利多卡因)或 B 组(n=33,0.3%BH)。参与者、护理人员和研究者均对分组情况不知情。每种研究药物均在插管前 10 秒对气管内导管(ETT)套囊喷三次。术后 24 小时内(在麻醉后护理病房期间以及气管拔管后 6、12 和 24 小时)记录 POST 的发生率和严重程度。对多重比较进行了 P 值调整。
共纳入 99 例患者。87 例患者完成了研究。气管拔管后 6 小时时,三组的 POST 发生率相似(C 组:31[93.9%],L 组:29[87.9%],B 组:27[81.8%];P=0.38)。然而,TT 后 12 和 24 小时时,三组的 POST 发生率有显著差异(12 小时:P=0.002,24 小时:P=0.01)。气管拔管后 POST 的严重程度在研究组之间存在统计学差异(6 小时:P=0.04,12 小时:P=0.01)。未观察到不良反应。
BH 喷雾应用于 ETT 套囊可降低 TT 后 12 小时时 POST 的发生率和严重程度。我们建议这种方法是一种无创伤、有效的 POST 管理选择,无严重副作用。
临床研究信息服务(KCT0002627);2017 年 11 月 24 日注册。