Chung Chan Jong, Jeong Seong Yeop, Jeong Joon Ho, Kim Sung Wan, Lee Kyung Hyun, Kim Jeong Ho, Park Sang Yoong, Choi So Ron
Department of Anesthesiology and Pain Medicine, Dong-A University School of Medicine, Busan, Korea.
Anesth Pain Med (Seoul). 2021 Apr;16(2):163-170. doi: 10.17085/apm.20082. Epub 2021 Apr 15.
Sore throat and hoarseness frequently occur following general anesthesia with tracheal intubation and are effectively reduced when dexamethasone is used prophylactically. Alchemilla vulgaris in glycerine (Neo Mucosal Activator®) suppresses inflammatory response, possibly relieving sore throat.
We enrolled 94 patients (age ≥ 18 years) scheduled for thoracic surgery using double-lumen tube intubation. Before intubation, 0.2 mg/kg of dexamethasone was administered intravenously and 2 ml of normal saline was sprayed into the oropharyngeal cavity (Group D; n = 45), or 0.04 ml/kg normal saline was administered intravenously and 1 g of Neo Mucosal Activator® mixed with 1 ml of normal saline was sprayed into the oropharyngeal cavity (Group N; n = 43), in a double blind and prospectively randomized manner. Postoperative sore throat and hoarseness were recorded using a numeral rating scale and a 4-point scale to detect a change in voice quality following tracheal extubation (at 1, 6, and 24 h). The primary outcome was the incidence of sore throat at 24 h following surgery. The secondary outcomes were incidence and severity of sore throat and hoarseness.
There were no significant differences in the incidence of sore throat at 24 h following surgery (57.8% vs. 46.5%; P = 0.290) or in the incidence and intensity of sore throat and hoarseness at 1, 6, and 24 h following surgery between the groups.
A. vulgaris in glycerine did not significantly differ from dexamethasone for preventing sore throat and hoarseness owing to intubation.
气管插管全身麻醉后常出现咽痛和声音嘶哑,预防性使用地塞米松可有效减轻症状。甘油委陵菜(新黏膜活化剂®)可抑制炎症反应,可能缓解咽痛。
我们纳入了94例计划行双腔管插管胸科手术的患者(年龄≥18岁)。插管前,以双盲和前瞻性随机方式,静脉注射0.2mg/kg地塞米松并向口咽腔喷洒2ml生理盐水(D组;n = 45),或静脉注射0.04ml/kg生理盐水并向口咽腔喷洒1g新黏膜活化剂®与1ml生理盐水的混合液(N组;n = 43)。术后使用数字评分量表和4分制量表记录咽痛和声音嘶哑情况,以检测气管拔管后(1、6和24小时)声音质量的变化。主要结局是术后24小时咽痛的发生率。次要结局是咽痛和声音嘶哑的发生率及严重程度。
两组术后24小时咽痛发生率(57.8%对46.5%;P = 0.290)以及术后1、6和24小时咽痛和声音嘶哑的发生率及严重程度均无显著差异。
甘油委陵菜在预防插管引起的咽痛和声音嘶哑方面与地塞米松无显著差异。