Chogyoji Yuki, Watanabe Seiji
Graduate student, Graduate School of Dentistry, Kyushu Dental University, Fukuoka, Japan.
Professor and Chairperson, Division of Dental Anesthesiology, Department of Science of Physical Functions, Kyushu Dental University, Fukuoka, Japan.
Anesth Prog. 2020 Jun 1;67(2):79-85. doi: 10.2344/anpr-66-04-07.
This study investigated the effectiveness of subglottic irrigation (SI) with 100 mL of saline on reducing bacterial contamination in the subglottic space during oral surgery procedures without the use of throat packs. Subglottic lavage and irrigation were performed through the suction lumen located on specialized endotracheal tubes (ETTs) with capabilities of permitting evacuation from the subglottic space. Fifty-three patients who were scheduled for oral surgery procedures under general anesthesia while intubated with specialized ETTs at Kyushu Dental University Hospital were enrolled in this study. Subglottic irrigation was performed, and the sample fluid was collected through the ETT suction lumen for smear and culture bacterial examinations after 3 points in time: immediately after intubation, after completing the surgical procedure, and again after SI. Oral surgery without a throat pack significantly increased bacterial contamination in the subglottic lavage (p < .001), and SI decreased bacterial contamination (p < .001) similarly to levels found after tracheal intubation. Subglottic irrigation with 100 mL of saline was effective in reducing bacterial load in the subglottic space to levels similarly noted immediately after intubation for patients undergoing intraoral surgical procedures without the use of a throat pack.
本研究调查了在不使用喉罩的口腔外科手术过程中,100毫升生理盐水进行声门下冲洗(SI)对减少声门下间隙细菌污染的有效性。声门下灌洗和冲洗通过位于专门气管内导管(ETT)上的吸引腔进行,该导管具有从声门下间隙排出液体的能力。九州牙科大学医院53例计划在全身麻醉下使用专门ETT插管进行口腔外科手术的患者纳入本研究。进行声门下冲洗,并在3个时间点后通过ETT吸引腔收集样本液体进行涂片和培养细菌检查:插管后立即、手术完成后以及声门下冲洗后。不使用喉罩的口腔外科手术显著增加了声门下灌洗中的细菌污染(p < .001),声门下冲洗降低了细菌污染(p < .001),与气管插管后发现的水平相似。对于不使用喉罩进行口腔内手术的患者,100毫升生理盐水声门下冲洗有效地将声门下间隙的细菌载量降低到插管后立即观察到的相似水平。