Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
Clin Oral Investig. 2022 Nov;26(11):6795-6804. doi: 10.1007/s00784-022-04641-4. Epub 2022 Jul 29.
Throat packs (TP) are used in upper airway surgery to avoid accumulation and aspiration of blood, foreign bodies, and fluids. But side effects such as sore throat and TP retention have been reported and challenge the standardized use of TP. The aim of this study is to compare benefits and side effects of TP versus no TP for upper airway procedures in intubation anesthesia.
One hundred forty-eight patients with surgical interventions at the upper airway under intubation anesthesia were included. Of those, n = 74 each were treated without (A, control) and with (B) TP. Study group B was subdivided whether TP was placed by the surgeon (B1; n = 37) or by the anesthesiologist (B2; n = 37). TP-related side effects such as sore throat, foreign body sensation, hoarseness, dyspnea, difficulty of swallowing, nausea, retching, nausea, aspiration, and pneumonia as well as the influence of TP design and the applicant (surgeon or anesthetist) were analyzed.
A significantly increased rate of difficulty of swallowing (p = 0.045), intensity of sore throat (p = 0.04), and foreign body sensation (p = 0.024) was found in group B when compared to group A. There was no correlation between hoarseness, dyspnea, nausea, retching, and TP. No case of aspiration or pneumonia was seen but one TP was accidentally forgotten in the patient. B2 showed an increased frequency of difficulty swallowing, followed by A and B1. B1 led to the highest incidence of nausea followed by the A and B2.
The use of TP led to a high rate of side effects without showing the propagated advantages.
The use of TP must be considered critically and cannot generally be recommended without specific reasons, such as high aspiration risk.
咽喉填塞物（TP）用于上气道手术，以避免血液、异物和液体的积聚和吸入。但已有报道称，TP 会引起咽痛和 TP 滞留等副作用，这给 TP 的标准化使用带来了挑战。本研究旨在比较上气道插管麻醉手术中使用和不使用 TP 的益处和副作用。
纳入 148 例接受插管麻醉下上气道手术的患者。其中，每组 n = 74 例，分别不使用（A，对照组）和使用（B）TP 治疗。研究组 B 进一步分为由外科医生（B1；n = 37）或麻醉师（B2；n = 37）放置 TP。分析了与 TP 相关的副作用，如咽痛、异物感、声音嘶哑、呼吸困难、吞咽困难、恶心、呕吐、恶心、误吸和肺炎，以及 TP 设计和申请人（外科医生或麻醉师）的影响。
与 A 组相比，B 组吞咽困难（p = 0.045）、咽痛（p = 0.04）和异物感（p = 0.024）的发生率显著增加。B 组与 B1 组无声音嘶哑、呼吸困难、恶心、呕吐与 TP 相关。未发生误吸或肺炎，但有一例 TP 意外遗忘在患者体内。B2 组吞咽困难的发生率较高，其次是 A 组和 B1 组。B1 组恶心发生率最高，其次是 A 组和 B2 组。
使用 TP 会导致很高的副作用发生率，而没有显示出预期的优势。
除非有高误吸风险等特殊原因，否则必须慎重考虑使用 TP，一般不建议常规使用。
