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术前使用右美托咪定、氯胺酮或生理盐水雾化吸入减少术后咽痛:一项前瞻性随机对照试验。

Reduction in postoperative sore throat by preoperative nebulization with dexmedetomidine, ketamine or saline: A prospective, randomized-controlled trial.

作者信息

Ittoop Amanta L, Gupta Priyanka, Jain Gaurav, Tyagi Nidhi, Eda Jhansi, Shajahan Shafiq

机构信息

Department of Anaesthesiology, 6 Level, Medical College Building, All India Institute of Medical Sciences (A. I. I. M. S), Rishikesh, Uttarakhand, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2023 Apr-Jun;39(2):201-207. doi: 10.4103/joacp.joacp_245_21. Epub 2023 Apr 25.

Abstract

BACKGROUND AND AIMS

Postoperative sore throat (POST) is a minor but distressing complication following general anesthesia. The current literature on the effect of preoperative nebulization with dexmedetomidine, or ketamine on POST is, however, sparse. So, we compared the effect of preoperative nebulization with these drugs on POST.

MATERIAL AND METHODS

One hundred and thirty-two American Society of Anaesthesiology (ASA) grade I-II patients undergoing elective laparoscopic surgeries under general anesthesia were randomized into three equal groups: D, K, or C to receive dexmedetomidine, ketamine, or saline as preoperative nebulization, respectively. The primary objective was to compare the incidence and severity of POST, as inferred from the patient interviews at 2, 6, 12, 24-h postoperatively.

RESULTS

Group D had a significantly lower incidence (29.5%) and severity (12: mild; 1: moderate) of POST compared to group K (54.5% [21: mild; 3: moderate]) and group C (56.8% [19: mild; 6: moderate]), at 2-h postoperatively. The same trend was observed at 6-h postoperatively (group D: 22.7% [9: mild; 1: moderate]); group K: (40.9% [17: mild; 1: moderate]); group C (50% [17: mild; 5: moderate]). The mean arterial pressure was significantly lower in group D at 15 min intraoperatively (84.09 mmHg, = 0.018) and immediate postoperatively (97.60 mmHg, = 0.034). The postoperative sedation, nausea, and vomiting was not statistically significant.

CONCLUSION

Preoperative nebulization with dexmedetomidine is effective in the reduction of the incidence and severity of early POST.

摘要

背景与目的

术后咽痛(POST)是全身麻醉后一种轻微但令人痛苦的并发症。然而,目前关于术前雾化右美托咪定或氯胺酮对POST影响的文献较少。因此,我们比较了术前雾化这些药物对POST的影响。

材料与方法

132例美国麻醉医师协会(ASA)I-II级择期全身麻醉下行腹腔镜手术的患者被随机分为三组,每组44例:D组、K组和C组,分别接受右美托咪定、氯胺酮或生理盐水进行术前雾化。主要目的是通过术后2、6、12、24小时对患者的访谈,比较POST的发生率和严重程度。

结果

术后2小时,D组POST的发生率(29.5%)和严重程度(轻度12例;中度1例)显著低于K组(54.5%[轻度21例;中度3例])和C组(56.8%[轻度19例;中度6例])。术后6小时观察到相同趋势(D组:22.7%[轻度9例;中度1例];K组:40.9%[轻度17例;中度1例];C组:50%[轻度17例;中度5例])。术中15分钟及术后即刻,D组平均动脉压显著降低(分别为84.09 mmHg,P = 0.018;97.60 mmHg,P = 0.034)。术后镇静、恶心和呕吐无统计学差异。

结论

术前雾化右美托咪定可有效降低早期POST的发生率和严重程度。

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