Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Armed Forces Capital Hospital, Seongnam, Korea.
Acta Anaesthesiol Scand. 2021 Feb;65(2):213-219. doi: 10.1111/aas.13705. Epub 2020 Sep 23.
Postoperative throat complications after intubation are undesirable but frequent outcomes. A randomized, double-blinded study was performed to determine whether thermal softening of endotracheal tubes reduced throat complications after intubation.
Patients (n = 196) undergoing nasal surgery were randomly allocated into the control group and thermal softening groups. Sore throat and hoarseness were evaluated 1 and 24 hours after extubation. The severity of sore throat was evaluated using the numeric rating scale (NRS). The primary outcome was the incidence of sore throat 1 hour after extubation and sore throat was defined as a painful or scratchy feeling in the throat. The secondary outcomes were the incidence of hoarseness 1 hour after extubation, the incidence of sore throat and hoarseness 24 hours after extubation, severity of sore throat, and vocal cord injuries.
The incidence of sore throat 1 hour after extubation was lower in the thermal softening group than in the control group (35.1% vs 52.7%, P = .02). Moreover, thermal softening decreased the mean NRS score for sore throat in the thermal softening group by 10% an hour after extubation (thermal softening group, 1.29 [95% CI, 0.88-1.70] vs control group, 2.33 [95% CI, 1.77-2.89]; P < .01). At 24 hours after extubation, the incidence of sore throat (38.3% vs 40.7%, P = .77) and hoarseness (34.0% vs 35.2%, 0.95 [0.52-1.74], P = .74) were comparable between the two groups.
Intubation using endotracheal tubes with thermal softening significantly decreased the incidence of sore throat 1 hour after extubation when compared with endotracheal tubes without thermal softening.
插管后咽喉并发症是不理想但常见的后果。本研究采用随机、双盲的方法来确定气管导管热软化是否能减少插管后的咽喉并发症。
接受鼻手术的患者(n=196)被随机分配到对照组和热软化组。拔管后 1 小时和 24 小时评估咽喉痛和声音嘶哑。采用数字评分量表(NRS)评估咽喉痛的严重程度。主要结局是拔管后 1 小时咽喉痛的发生率,定义为咽喉疼痛或刺痛感。次要结局是拔管后 1 小时声音嘶哑的发生率、拔管后 24 小时咽喉痛和声音嘶哑的发生率、咽喉痛的严重程度和声带损伤。
与对照组相比,热软化组拔管后 1 小时咽喉痛的发生率较低(35.1% vs 52.7%,P=0.02)。此外,热软化组拔管后 1 小时 NRS 评分降低了 10%(热软化组 1.29 [95%CI,0.88-1.70] vs 对照组 2.33 [95%CI,1.77-2.89];P<0.01)。拔管后 24 小时,两组咽喉痛(38.3% vs 40.7%,P=0.77)和声音嘶哑(34.0% vs 35.2%,0.95 [0.52-1.74],P=0.74)的发生率无显著差异。
与未进行热软化的气管导管相比,使用热软化气管导管可显著降低拔管后 1 小时咽喉痛的发生率。