Department of Dental Anesthesiology, Graduate School of Dental Science, Kyushu University, Fukuoka, Japan.
Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
BMC Anesthesiol. 2024 Nov 18;24(1):419. doi: 10.1186/s12871-024-02807-z.
In oral maxillofacial surgery, the nasal tracheal tube is mostly used to provide a better surgical field for oral, head and neck operations. Postoperative sore throat and hoarseness are common following tracheal intubation, with an incidence of 11-55%. Then, we previously reported advantage technique of fiberoptic scope to decrease the risk which the tip of the tube is visualized as the tube is advanced which helps avoid impingement of the tube. However, the extent to which this technique causes postoperative complications is unknown compared to traditional technique. The aim of this study was retrospectively to determine the effect of postoperative sore throat following nasotracheal intubation by tip of the tube is visualized by fiberoptic scope.
Anesthesia records of the adult patients with nasotracheal intubation were checked. Patients underwent oral maxillofacial surgery from January 2021 until March 2023. Facilitated with rocuronium, nasotracheal intubation was performed using the traditional or observative method by fiberoptic scope with a 4.8 mm outer diameter. Intubation was performed with a cuffed 6.5-8.0 mm ID nasotracheal tube. The following variables were recorded: gender, age, height, weight, ASA classification, anesthesia time, duration of intubation, tube size, intubation attempts, fentanyl and remifentanil. The postoperative sore throat and the incidence of hoarseness were recorded at operative day and at the day after operative day, and the time to recovery.
A total of 104 cases (traditional fiberoptic intubation n = 51, observative fiberoptic intubation n = 53) were enrolled in this retrospective study. There were no significant differences in clinical characteristics and anesthetic data. There was not significant difference in incidence of postoperative sore throat, hoarseness and recovery between the two groups (P = 0.61, 0.44, 0.90). For subjects reporting postoperative sore throat (n = 30), there was not a significant difference in VAS means at operative day and at the day after operative day between the two groups (P = 0.81, 0.91).
We found that postoperative sore throat and recovery were not influenced by observative fiberoptic scope for nasotracheal intubation.
在口腔颌面外科中，鼻气管导管主要用于为口腔、头颈部手术提供更好的手术视野。气管插管后常出现咽喉痛和声音嘶哑，发生率为 11-55%。我们之前报道了使用纤维喉镜观察管尖以降低管尖被视为管尖推进时风险的优势技术，这有助于避免管的撞击。然而，与传统技术相比，这种技术引起术后并发症的程度尚不清楚。本研究旨在回顾性确定通过纤维喉镜观察管尖对经鼻气管插管后咽喉痛的影响。
检查接受经鼻气管插管的成年患者的麻醉记录。患者于 2021 年 1 月至 2023 年 3 月接受口腔颌面外科手术。在罗库溴铵的辅助下，使用外径为 4.8mm 的传统或观察纤维喉镜进行经鼻气管插管。使用带套囊的 6.5-8.0mmID 经鼻气管导管进行插管。记录以下变量：性别、年龄、身高、体重、ASA 分级、麻醉时间、插管时间、管腔大小、插管尝试次数、芬太尼和瑞芬太尼。记录手术当天和术后第二天的咽喉痛和声音嘶哑发生率以及恢复时间。
本回顾性研究共纳入 104 例（传统纤维喉镜插管 n=51，观察纤维喉镜插管 n=53）。两组患者的临床特征和麻醉数据无显著差异。两组术后咽喉痛、声音嘶哑和恢复的发生率无显著差异（P=0.61，0.44，0.90）。对于报告术后咽喉痛的受试者（n=30），两组在手术当天和术后第二天的 VAS 平均值无显著差异（P=0.81，0.91）。
我们发现观察纤维喉镜用于经鼻气管插管不会影响术后咽喉痛和恢复。
