Gupta Priyamvada, Sharma Sunita, Vishnoi Anshul, Kanoji Sakshi, Moin Khayyam
Department of Critical Care, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
Department of Neuroanesthesia, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
Anesth Essays Res. 2022 Jul-Sep;16(3):311-315. doi: 10.4103/aer.aer_91_22. Epub 2022 Nov 25.
While administering general anesthesia requiring endotracheal intubation, it is a common practice to inflate the cuff with air. Continuous pressure exerted by cuff on mucosa may lead to postoperative complaints such as sore throat, cough, and dysphagia, which are very disturbing to the patient. Hence, we hypothesized that inflation of cuff with propofol may reduce the incidence of these complications as a result of cushioning effect as well as non-diffusion of nitrous oxide into it. Our aim was to compare the effects of inflation of endotracheal tube cuff with 0.9% saline, 4% lignocaine, and 1% propofol on the incidence of postoperative morbidity in terms of cough, sore throat, dysphonia, and dysphagia with general anesthesia using nitrous oxide.
Patients scheduled for elective surgery under general anesthesia were randomly allocated into four equal groups of thirty each as per cuff inflation media: air (Group A), 0.9% saline (Group S), 4% lidocaine (Group L), and 1% propofol (Group P). The incidence of cough was noted at 15, 30 and 60 min after extubating. The occurrence and severity of postoperative sore throat (POST) was evaluated at 2, 6, and 24 h after extubating.
The incidence of cough was maximum in Group A and minimum in Group P ( < 0.05). The occurrence of POST was highest in Group A, followed by Group S and Group L, and least in Group P. The hemodynamic parameters were comparable with no statistical difference in all the four groups ( < 0.05).
The intracuff 1% propofol is superior to 4% xylocaine and normal saline in the prevention of cough and sore throat postoperatively, whereas inflation of cuff with air leads to maximum incidence of these complications.
在实施需要气管插管的全身麻醉时，向气管导管套囊内充气是常见的操作。套囊对黏膜持续施加压力可能导致术后出现咽痛、咳嗽和吞咽困难等不适，给患者带来很大困扰。因此，我们推测用丙泊酚充盈套囊可能由于其缓冲作用以及氧化亚氮不会扩散入内，从而降低这些并发症的发生率。我们的目的是比较用0.9%生理盐水、4%利多卡因和1%丙泊酚充盈气管导管套囊对使用氧化亚氮全身麻醉术后咳嗽、咽痛、声音嘶哑和吞咽困难等并发症发生率的影响。
计划在全身麻醉下进行择期手术的患者，根据套囊充气介质随机分为四组，每组30人：空气组（A组）、0.9%生理盐水组（S组）、4%利多卡因组（L组）和1%丙泊酚组（P组）。记录拔管后15、30和60分钟时咳嗽的发生率。在拔管后2、6和24小时评估术后咽痛（POST）的发生情况和严重程度。
A组咳嗽发生率最高，P组最低（P<0.05）。POST的发生率A组最高，其次是S组和L组，P组最低。四组的血流动力学参数具有可比性，无统计学差异（P<0.05）。
套囊内注入1%丙泊酚在预防术后咳嗽和咽痛方面优于4%利多卡因和生理盐水，而用空气充盈套囊会导致这些并发症的发生率最高。
