鼻腔夹板和口呼吸训练可减少鼻内镜鼻窦手术后苏醒期谵妄：一项随机对照试验。
Nasal splinting and mouth breathing training reduce emergence delirium after endoscopic sinus surgery: a randomized controlled trial.
机构信息
Department of Anesthesiology, Shanghai General Hospital of Nanjing Medical University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.
Department of Medical Affairs, Gumei Community Health Service Center, Shanghai Medical College Fudan University, Shanghai, China.
出版信息
BMC Anesthesiol. 2023 Sep 7;23(1):302. doi: 10.1186/s12871-023-02262-2.
BACKGROUND
Emergence delirium (ED) is generally occurred after anesthesia associated with increased risks of long-term adverse outcomes. Therefore, this study aimed to evaluate the efficacy of preconditioning with nasal splint and mouth-breathing training on prevention of ED after general anesthesia.
METHODS
This randomized controlled trial enrolled 200 adult patients undergoing ESS. Patients were randomized to receive either nasal splinting and mouth breathing training (n = 100) or standard care (n = 100) before surgery. The primary outcome was the occurrence of ED within 30 min of extubation, assessed using the Riker Sedation-Agitation Scale. Logistic regression identified risk factors for ED.
RESULTS
Totally 200 patients were randomized and 182 aged from 18 to 82 years with 59.9% of males were included in the final analysis (90 in C-group and 92 in P-group). ED occurred in 16.3% of the intervention group vs. 35.6% of controls (P = 0.004). Male sex, smoking and function endoscopic sinus surgery (FESS) were independent risk factors for ED.
CONCLUSIONS
Preoperative nasal splinting and mouth breathing training significantly reduced the incidence of emergence delirium in patients undergoing endoscopic sinus surgery.
TRIAL REGISTRATION
ChiCTR1900024925 ( https://www.chictr.org.cn/index.aspx ) registered on 3/8/2019.
背景
麻醉后谵妄（ED）通常会发生，并增加长期不良后果的风险。因此，本研究旨在评估鼻夹板和口呼吸训练对预防全身麻醉后 ED 的效果。
方法
这是一项随机对照试验，纳入了 200 例接受 ESS 的成年患者。患者随机分为接受鼻夹板和口呼吸训练（n=100）或标准护理（n=100）组，在术前接受治疗。主要结局是拔管后 30 分钟内发生 ED 的情况，采用 Riker 镇静-躁动量表进行评估。使用逻辑回归识别 ED 的危险因素。
结果
共 200 例患者被随机分组，其中 182 例（男 59.9%）年龄 18-82 岁纳入最终分析（C 组 90 例，P 组 92 例）。干预组的 ED 发生率为 16.3%，对照组为 35.6%（P=0.004）。男性、吸烟和功能性内镜鼻窦手术（FESS）是 ED 的独立危险因素。
结论
术前鼻夹板和口呼吸训练可显著降低内镜鼻窦手术患者 ED 的发生率。
试验注册
ChiCTR1900024925（https://www.chictr.org.cn/index.aspx），于 2019 年 3 月 8 日注册。
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