Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Anesthesiology, Nagoya University Hospital, Nagoya, Japan.
Nagoya J Med Sci. 2022 May;84(2):319-326. doi: 10.18999/nagjms.84.2.319.
i-gel™ is a supraglottic airway device widely used for airway management during general anesthesia as an alternative to tracheal intubation. It sometimes results in a sore throat postoperatively; however, the risk factors for a postoperative sore throat caused by i-gel remain unclear. Here, we clarify the risk factors for a postoperative sore throat associated with i-gel insertion. We retrospectively reviewed the data of 426 adult patients who received general anesthesia with i-gel at our institution from January 2018 to December 2019. The incidence of postoperative sore throat and intraoperative data (size of i-gel, number of insertion attempts, total insertion time, and dose of the neuromuscular blocker and opioid) were evaluated. Logistic regression analysis was performed to identify the risk factors. Postoperative sore throat following i-gel insertion occurred in 24/426 patients (5.6%). The insertion time was significantly associated with the incidence of postoperative sore throat in the univariate analysis, but not in the multivariate analysis (=0.519). Increased doses of neuromuscular blockers before i-gel insertion (odds ratio [OR], 5.46; 95% confidence interval [CI], 1.50-19.80; =0.001) and reduced doses of intraoperative fentanyl (OR, 0.51; 95% CI, 0.28-0.93; =0.028) were risk factors in the univariate and multivariate analyses. In the subgroup that used neuromuscular blockers before i-gel insertion, only an increased dose of neuromuscular blocker (OR, 17.2; 95%, CI 1.06-280; =0.046) was an associated risk factor in the univariate and multivariate analyses. Overall, increased doses of neuromuscular blockers before i-gel insertion could contribute to the development of postoperative sore throat.
i-gel™ 是一种常用于全身麻醉时的声门上气道装置，可作为气管插管的替代方法。它有时会导致术后喉咙痛;然而，i-gel 引起术后喉咙痛的危险因素尚不清楚。在这里，我们阐明了与 i-gel 插入相关的术后喉咙痛的危险因素。我们回顾性分析了 2018 年 1 月至 2019 年 12 月在我院接受全身麻醉并使用 i-gel 的 426 例成年患者的数据。评估了术后喉咙痛和术中数据( i-gel 大小、插入尝试次数、总插入时间以及神经肌肉阻滞剂和阿片类药物的剂量)。进行了逻辑回归分析以确定危险因素。426 例患者中有 24 例(5.6%)在插入 i-gel 后出现喉咙痛。单因素分析显示插入时间与术后喉咙痛的发生率显著相关，但多因素分析则不然(=0.519)。i-gel 插入前神经肌肉阻滞剂剂量增加(比值比[OR]，5.46;95%置信区间[CI]，1.50-19.80;=0.001)和术中芬太尼剂量减少(OR，0.51;95%CI，0.28-0.93;=0.028)是单因素和多因素分析中的危险因素。在使用神经肌肉阻滞剂之前使用 i-gel 的亚组中，只有增加的神经肌肉阻滞剂剂量(OR，17.2;95%CI，1.06-280;=0.046)是单因素和多因素分析中的相关危险因素。总的来说，i-gel 插入前增加神经肌肉阻滞剂的剂量可能导致术后喉咙痛的发生。
