Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China.
BMC Anesthesiol. 2021 Oct 2;21(1):237. doi: 10.1186/s12871-021-01458-8.
Uvulopalatopharyngoplasty(UPPP) is the most prevalent surgical treatment of obstructive sleep apnea, but postoperative pharyngeal pain may affect patient comfort. The enhanced recovery after surgery pathway has been proved beneficial to many types of surgery but not to UPPP yet. The aim of this pilot study was to preliminarily standrize an enhanced recovery after surgery protocol for UPPP, to assess whether it has positive effects on reducing postoperative pharyngeal pain and improving patient comfort, and to test its feasibility for an international multicentre study.
This randomised controlled study analysed 116 patients with obstructive sleep apnoea (OSA) who were undergoing UPPP in a single tertiary care hospital. They were randomly divided according to treatment: the ERAS group (those who received ERAS treatment) and the control group (those who received traditional treatment). Ninety-five patients completed the assessment (ERAS group, 59 patients; control group, 36 patients). Pharyngeal pain and patient comfort were evaluated using a visual analogue scale (VAS) at 30 min and at 6, 12, 24 and 48 h after UPPP. Complications, hospitalisation duration, and hospital cost were recorded.
The VAS scores for resting pain and swallowing pain were significantly lower in the ERAS group than those in the control group at 30 min and at 6, 12, 24 and 48 h after surgery. Patient comfort was improved in the ERAS group. The hospitalisation duration and cost were comparable between the groups. The incidence of complications showed an increasing trend in the ERAS group.
The ERAS protocol significantly relieved pharyngeal pain after UPPP and improved comfort in patients with OSA, which showed the prospect for an larger study. Meanwhile a potential increase of post-operative complications in the ERAS group should be noticed.
Chinese Clinical Trial Registry (23/09/2018, ChiCTR1800018537 ).
悬雍垂腭咽成形术（UPPP）是治疗阻塞性睡眠呼吸暂停最常见的手术方法，但术后咽部疼痛可能会影响患者舒适度。术后加速康复（ERAS）方案已被证明对许多类型的手术有益，但尚未应用于 UPPP。本研究旨在初步制定 UPPP 的 ERAS 方案，评估其是否能减轻术后咽部疼痛，提高患者舒适度，并检验其在国际多中心研究中的可行性。
这是一项在一家三级医院进行的随机对照研究，分析了 116 例接受 UPPP 的阻塞性睡眠呼吸暂停（OSA）患者。他们根据治疗方法分为两组：ERAS 组（接受 ERAS 治疗）和对照组（接受传统治疗）。共有 95 例患者完成了评估（ERAS 组 59 例，对照组 36 例）。术后 30 分钟及 6、12、24 和 48 小时，采用视觉模拟量表（VAS）评估咽部疼痛和患者舒适度。记录并发症、住院时间和住院费用。
与对照组相比，ERAS 组术后 30 分钟及 6、12、24 和 48 小时时静息痛和吞咽痛的 VAS 评分均显著降低，患者舒适度提高。两组的住院时间和费用无差异。ERAS 组的并发症发生率呈上升趋势。
ERAS 方案可显著减轻 OSA 患者 UPPP 后的咽部疼痛，提高舒适度，有望进行更大规模的研究。同时，ERAS 组术后并发症的发生率可能增加，应予以关注。
中国临床试验注册中心（ChiCTR1800018537，2018 年 9 月 23 日）。
