Senol Celik Sevilay, Chalkias Athanasios, Sariköse Seda, Nur Arslan Hande, Bahramifar Ali, Rahimi-Bashar Farshid, Ait Hssain Ali, Hashemi Saeed, Vahedian-Azimi Amir
Koç University, School of Nursing, İstanbul, Turkey.
Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Outcomes Research Consortium, Cleveland, OH 44195, USA; Department of Intensive Care Medicine, Tzaneio General Hospital, Piraeus, Greece.
Intensive Crit Care Nurs. 2024 Oct;84:103728. doi: 10.1016/j.iccn.2024.103728. Epub 2024 Jun 10.
To evaluate the effectiveness of peri-intubation non-pharmacological interventions in reducing postoperative sore throat (POST), cough (PEC), and hoarseness in surgical patients.
A systematic review with meta-analysis and meta-regression.
Elective surgery under general anesthesia in operating rooms.
Evaluate the impact of non-pharmacological interventions, including pre-intubation (gargling with Sodium Azulene Sulfonate, licorice, or using Strepsils tablets of honey and lemon lozenge), during-intubation (inflating the TT cuff with normal saline and softening the ETT cuff with warm normal saline), and post-intubation (cold vapor therapy, gargling with honey lemon water, and using green tea gargle), on the occurrence of POST, PEC, and hoarseness.
Nineteen trials with 2,136 participants were included. Pre-intubation intervention significantly reduced POST immediately after extubation (n = 861; OR: 0.28, 95 % CI: 0.20-0.38, P < 0.001), and 24 h post-extubation (n = 1006; OR: 0.21, 95 % CI: 0.16-0.28, P < 0.001). During-intubation intervention did not show significant effects on POST. Pre-intubation intervention also reduced POST-associated pain score at 24 h post-extubation (n = 440; MD: -0.50, 95 % CI: -0.81 to -0.18, P < 0.001). Post-intubation interventions were effective in reducing POST-associated pain scores at different time points post-extubation (P < 0.05). Pre-intubation intervention significantly reduced PEC (OR: 0.13, 95 % CI: 0.02-0.70, P = 0.02) and hoarseness (OR: 0.36, 95 %CI: 0.15-0.86, P = 0.02) at 24 h post-extubation. However, during-intubation interventions did not reduce hoarseness at 24 h post-extubation.
Pre-intubation non-pharmacological interventions were found to be the most effective in reducing the incidence and severity of POST, PEC, and hoarseness.
Implementing pre-intubation non-pharmacological interventions can be beneficial for bedside nurses and healthcare professionals in reducing postoperative complications and nurses can contribute to improving patient comfort and recovery outcomes following surgery.
The protocol was registered in the PROSPERO international prospective register of systematic reviews on 2 January 2024 (CRD42023492813).
评估插管周围非药物干预措施在降低手术患者术后咽痛（POST）、咳嗽（PEC）和声音嘶哑方面的有效性。
一项采用荟萃分析和荟萃回归的系统评价。
手术室全身麻醉下的择期手术。
评估非药物干预措施的影响，包括插管前（用 azulene 磺酸钠、甘草含漱，或使用蜂蜜柠檬含片的 Strepsils 片）、插管期间（用生理盐水充盈气管导管套囊并用温生理盐水软化气管导管套囊）和插管后（冷蒸汽疗法、用蜂蜜柠檬水含漱、用绿茶含漱）对 POST、PEC 和声音嘶哑发生情况的影响。
纳入了 19 项试验，共 2136 名参与者。插管前干预显著降低了拔管后即刻（n = 861；OR：0.28，95%CI：0.20 - 0.38，P < 0.001）和拔管后 24 小时（n = 1006；OR：0.21，95%CI：0.16 - 0.28，P < 0.001）的 POST。插管期间干预对 POST 未显示出显著影响。插管前干预还降低了拔管后 24 小时与 POST 相关的疼痛评分（n = 440；MD：-0.50，95%CI：-0.81 至 -0.18，P < 0.001）。插管后干预在拔管后不同时间点有效降低了与 POST 相关的疼痛评分（P < 0.05）。插管前干预显著降低了拔管后 24 小时的 PEC（OR：0.13，95%CI：0.02 - 0.70，P = 0.02）和声音嘶哑（OR：0.36，95%CI：0.15 - 0.86，P = 0.02）。然而，插管期间干预在拔管后 24 小时未降低声音嘶哑。
发现插管前非药物干预措施在降低 POST、PEC 和声音嘶哑的发生率及严重程度方面最有效。
实施插管前非药物干预措施对床边护士和医疗保健专业人员减少术后并发症可能有益，护士可有助于提高患者术后舒适度和恢复结果。
该方案于 2024 年 1 月 2 日在 PROSPERO 国际前瞻性系统评价注册库中注册（CRD42023492813）。
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