气管导管软化对术后声音嘶哑和咽痛减轻的影响。

The Effect of Softening of Endotracheal Tubes on the Decrement of Postoperative Hoarseness and Sore Throat.

作者信息

Mohseni Masood, Farahmand Rad Reza, Jafarian Ali Akbar, Zarisfi Amir Hossein, Masoudi Nasim

机构信息

Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Pain Med. 2022 Nov 15;12(5):e123910. doi: 10.5812/aapm-123910. eCollection 2022 Oct.

DOI:10.5812/aapm-123910

PMID:36937172

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10016123/

Abstract

BACKGROUND

Hoarseness, cough, and sore throat are the most prevalent complications after removing patients' endotracheal tube and general anesthesia. Various methods have been proposed to reduce these complications after intubation.

OBJECTIVES

The present study aimed to assess the effect of softening the endotracheal tube with normal warm saline on reducing post-intubation complications such as sore throat and hoarseness.

METHODS

This double-blind, randomized controlled trial was performed on patients undergoing general anesthesia at Rasoul Akram and Firoozgar hospitals in Tehran, Iran. In the present study, 58 patients were randomly divided into 2 groups of 29 patients. All patients underwent the same premedication with fentanyl and lidocaine. Anesthesia was induced with propofol and atracurium. Three to 5 minutes after atracurium injection, the laryngoscopy test was performed. Randomly, some patients were intubated with a thermally softened endotracheal tube, and some were intubated with a normal tube. At the end of the operation, when the spontaneous breathing was adequate, and the patients could carry out oral instructions, the endotracheal tube was removed immediately after suctioning. All patients were evaluated for sore throat and hoarseness before discharge from recovery and 24 hours after surgery. The obtained data were analyzed using SPSS software package version 25.

RESULTS

The mean incidence of sore throat in recovery in the intervention group (20.7%) decreased compared to the control group (75.8%). Moreover, the mean incidence of hoarseness in the intervention group (17.2%) decreased in comparison to the control group (41.4%, P < 0.029). Based on the data of our study, we observed that 24 hours after surgery, the mean incidence of sore throat among the patients of the intervention group was significantly lower compared to the control group, where patients in the intervention group did not feel any sore throat (P < 0.002). We also observed that 24 hours after surgery, the amount of hoarseness in the intervention group (3.4%) also decreased compared to the control group (24.1%, P < 0.022).

CONCLUSIONS

Based on the results, it can be concluded that thermal softening of the endotracheal tubes with normal warm saline before intubation could be significantly effective in decrement of sore throat and hoarseness during recovery and 24 hours after surgery.

摘要

背景

声音嘶哑、咳嗽和咽痛是患者气管插管拔除及全身麻醉后最常见的并发症。人们提出了各种方法来减少插管后的这些并发症。

目的

本研究旨在评估用常温生理盐水软化气管插管对减少插管后诸如咽痛和声音嘶哑等并发症的效果。

方法

这项双盲、随机对照试验在伊朗德黑兰的拉苏勒·阿克拉姆医院和菲罗兹加尔医院接受全身麻醉的患者中进行。在本研究中，58例患者被随机分为两组，每组29例。所有患者均接受相同的芬太尼和利多卡因术前用药。用丙泊酚和阿曲库铵诱导麻醉。注射阿曲库铵3至5分钟后，进行喉镜检查。随机地，一些患者用热软化的气管插管进行插管，一些患者用普通插管进行插管。手术结束时，当自主呼吸充分且患者能够执行口头指令时，吸痰后立即拔除气管插管。在恢复室出院前和术后24小时对所有患者进行咽痛和声音嘶哑评估。使用SPSS 25版软件包对获得的数据进行分析。

结果

干预组恢复时咽痛的平均发生率（20.7%）与对照组（75.8%）相比有所降低。此外，干预组声音嘶哑的平均发生率（17.2%）与对照组（41.4%，P < 0.029）相比有所降低。根据我们的研究数据，我们观察到术后24小时，干预组患者咽痛的平均发生率显著低于对照组，干预组患者未感到任何咽痛（P < 0.002）。我们还观察到术后24小时，干预组声音嘶哑的程度（3.4%）也比对照组（24.1%，P < 0.022）有所降低。