Oji Moriyoshi, Koyama Yukihide, Oshika Hiroyuki, Kohno Masashi, Nakahashi Yusuke, Fukushima Sayano, Iwakura Hidemasa, Andoh Tomio
Department of Anesthesia, Tomei Atsugi Hospital, Atsugi, Japan.
Department of Anesthesiology, St. Marianna University School of Medicine, Kawasaki, Japan.
BMC Anesthesiol. 2019 Aug 31;19(1):169. doi: 10.1186/s12871-019-0837-0.
We previously demonstrated that lubrication of an endotracheal tube (ETT) cuff with K-Y™ jelly strongly and significantly inhibited the increase in cuff pressure during nitrous oxide (NO) exposure in vitro. However, in our previous study, we identified critical differences between some influential factors, such as the amount of lubricant retained on the cuff, and studied temperature differences between laboratory and clinical conditions. Therefore, it remained unclear whether this effect holds true in clinical settings.
We first sought to study how changes in the amount of K-Y™ jelly and temperature influence the inhibitory effects of the lubricant on the increase in NO-induced cuff pressure in vitro. Furthermore, we aimed to determine whether the application of K-Y™ jelly inhibits the increase in ETT cuff pressure during general anesthesia using NO in adult patients.
In the laboratory studies, we found that K-Y™ jelly inhibited the cuff pressure increase dose-dependently when the dose of K-Y™ jelly was varied (P = 0.02), and that such an inhibitory effect decreased with an increase in the studied temperature (P = 0.019). In the clinical study, lubrication with K-Y™ jelly slightly, but significantly, delayed the increase in ETT cuff pressure during general anesthesia with NO (P = 0.029). However, the inhibitory effect in the clinical settings was smaller than that in vitro.
Lubrication of the ETT cuff with K-Y™ jelly may delay the increase in cuff pressure during general anaesthesia with NO. However, the clinical significance of this effect may be limited.
UMIN Clinical Trials Registry: UMIN000031377 on March 1, 2019.
我们之前证明，在体外一氧化二氮（NO）暴露期间，用K-Y™ 啫喱润滑气管内导管（ETT）套囊可强烈且显著抑制套囊压力升高。然而，在我们之前的研究中，我们发现了一些影响因素之间的关键差异，如套囊上残留的润滑剂数量，并研究了实验室条件和临床条件之间的温度差异。因此，尚不清楚这种效应在临床环境中是否成立。
我们首先试图研究K-Y™ 啫喱用量和温度的变化如何影响润滑剂对体外NO诱导的套囊压力升高的抑制作用。此外，我们旨在确定在成年患者全身麻醉期间使用NO时，涂抹K-Y™ 啫喱是否能抑制ETT套囊压力升高。
在实验室研究中，我们发现当改变K-Y™ 啫喱的用量时，K-Y™ 啫喱剂量依赖性地抑制套囊压力升高（P = 0.02），并且这种抑制作用随着研究温度的升高而降低（P = 0.019）。在临床研究中，使用K-Y™ 啫喱润滑在全身麻醉期间使用NO时略微但显著地延迟了ETT套囊压力的升高（P = 0.029）。然而，临床环境中的抑制作用小于体外。
用K-Y™ 啫喱润滑ETT套囊可能会在使用NO的全身麻醉期间延迟套囊压力升高。然而，这种效应的临床意义可能有限。
UMIN临床试验注册中心：于2019年3月1日注册，注册号UMIN000031377。
