神经完整性监测肌电图型气管导管在成人中比标准气管导管引起更严重的术后咽喉痛：一项前瞻性队列研究。
A Neural Integrity Monitor Electromyography Endotracheal Tube Causes More Severe Postoperative Sore Throat Than a Standard Endotracheal Tube in Adults: A Prospective Cohort Study.
机构信息
Department of Anesthesiology, Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, NO.600, Yishan Road, Xuhui District, Shanghai, China.
Department of Anesthesiology, Shanghai Ocean University, No.999, Huchenghuan Road, Nanhui New City, Shanghai, China.
出版信息
World J Surg. 2023 Oct;47(10):2409-2415. doi: 10.1007/s00268-023-07092-4. Epub 2023 Aug 9.
BACKGROUND
This study aimed at figuring out the different effects of a neural integrity monitor electromyography endotracheal tube (NIM-EMG-ETT) and a standard endotracheal tube (ETT) on postoperative sore throat (POST).
METHODS
This prospective cohort study enrolled 143 patients scheduled to undergo general anesthesia with endotracheal intubation. Patients were allocated into three groups: Group A, non-thyroid surgery with a standard ETT; Group B, thyroid surgery with a standard ETT; Group C, thyroid surgery with a NIM-EMG-ETT. The incidence, the severity and visual analog scale (VAS) of POST were recorded. The incidence and the severity of POST were tested by χ test or Fisher's exact test. And VAS of POST was tested by Kruskal-Wallis test.
RESULTS
The incidences of POST in Group B and Group C were significantly higher than that of Group A at all the time points after extubation (P < 0.001). The incidences of POST in Group C was significantly higher than that in Group B at 8 h, 24 h and 48 h after extubation (89.4% vs. 68.8%, P = 0.014, relative risk (RR) 1.30, 95% confidence interval (CI) 1.05-1.61; 89.4% vs. 58.3%, P = 0.001, RR 1.53, 95% CI 1.18-1.98; 76.6% vs. 45.8%, P = 0.002, RR 1.67, 95% CI 1.18-2.36). Moreover, there was a significant higher VAS of POST and more serious POST with Group C than with Group B.
CONCLUSIONS
A NIM-EMG-ETT may induce higher incidence of POST and more serious POST than a standard ETT.
TRAIL REGISTRATION
Chinese Clinical Trail Registry ( http://www.chictr.org.cn/index.aspx , ChiCTR2200058896, 2022-4-18).
背景
本研究旨在探讨神经完整性监测肌电图气管内导管（NIM-EMG-ETT）与标准气管内导管（ETT）对术后咽喉痛（POST）的不同影响。
方法
这是一项前瞻性队列研究，纳入了 143 名拟行全身麻醉气管插管的患者。患者被分为三组：A 组，非甲状腺手术，使用标准 ETT；B 组，甲状腺手术，使用标准 ETT；C 组，甲状腺手术，使用 NIM-EMG-ETT。记录 POST 的发生率、严重程度和视觉模拟评分（VAS）。通过卡方检验或 Fisher 确切概率法检验 POST 的发生率和严重程度，通过 Kruskal-Wallis 检验检验 POST 的 VAS。
结果
拔管后所有时间点，B 组和 C 组的 POST 发生率均显著高于 A 组（P<0.001）。拔管后 8、24 和 48 小时，C 组的 POST 发生率显著高于 B 组（89.4%比 68.8%，P=0.014，相对危险度（RR）为 1.30，95%置信区间（CI）为 1.05-1.61；89.4%比 58.3%，P=0.001，RR 为 1.53，95%CI 为 1.18-1.98；76.6%比 45.8%，P=0.002，RR 为 1.67，95%CI 为 1.18-2.36）。此外，C 组的 POST VAS 评分更高，POST 更严重。
结论
NIM-EMG-ETT 可能比标准 ETT 引起更高的 POST 发生率和更严重的 POST。
试验注册
中国临床试验注册中心（http://www.chictr.org.cn/index.aspx，ChiCTR2200058896，2022-4-18）。
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