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经气管喷雾利多卡因对术后咽痛及插管血流动力学反应的疗效:一项随机对照试验。

Efficacy of lidocaine via trachospray in postoperative sore throat and hemodynamic response to intubation: a randomized controlled trial.

作者信息

Taşkın Kübra, Geyik Fatih Doğu, Arslan Gülten, Sezen Özlem, Çevik Banu

机构信息

Department of Anesthesiology and Reanimation, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey.

出版信息

BMC Anesthesiol. 2025 Mar 20;25(1):133. doi: 10.1186/s12871-025-03004-2.

DOI:10.1186/s12871-025-03004-2
PMID:40114047
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11924844/
Abstract

BACKGROUND

Postoperative sore throat (POST) is a common complication following endotracheal intubation after general anesthesia. This study aimed to examine the effect of administering lidocaine via the Trachospray device on POST severity and to assess its impact on hemodynamic responses (heart rate and blood pressure) during tracheal intubation.

METHODS

In a double-blind, randomized controlled trial was conducted, approved by the local ethics committee and registered on ClinicalTrials.gov. 100 patients aged 18-65 undergoing elective laparoscopic cholecystectomy and classified as ASA I-III were randomly divided into two groups. Group T received 10% lidocaine through Trachospray before intubation, while Group S was given distilled water. POST severity was evaluated at 2, 6, 12, and 24 h postoperatively. POST was evaluated on a 4-point scale, with scores of 0 (none) to 3 (severe).

RESULTS

Group T showed significantly lower POST severity and incidence at all time points compared to Group S (p = 0.001; p < 0.05). Additionally, hemodynamic responses (heart rate and blood pressure) were significantly lower in Group T following intubation (heart rate, p = 0.015; systolic blood pressure, p = 0.006; diastolic blood pressure, p = 0.010).

CONCLUSION

The use of 10% lidocaine via Trachospray before endotracheal intubation effectively decreases POST severity and incidence as well as the hemodynamic response to intubation, highlighting its potential to improve patient outcomes in the postoperative period.

摘要

背景

术后咽痛(POST)是全身麻醉后气管插管常见的并发症。本研究旨在探讨通过气管喷雾装置给予利多卡因对POST严重程度的影响,并评估其对气管插管期间血流动力学反应(心率和血压)的影响。

方法

在当地伦理委员会批准并在ClinicalTrials.gov注册的双盲、随机对照试验中,100例年龄在18 - 65岁、接受择期腹腔镜胆囊切除术且ASA分级为I - III级的患者被随机分为两组。T组在插管前通过气管喷雾给予10%利多卡因,而S组给予蒸馏水。术后2、6、12和24小时评估POST严重程度。POST采用4分制评估,分数从0(无)到3(严重)。

结果

与S组相比,T组在所有时间点的POST严重程度和发生率均显著降低(p = 0.001;p < 0.05)。此外,插管后T组的血流动力学反应(心率和血压)显著降低(心率,p = 0.015;收缩压,p = 0.006;舒张压,p = 0.010)。

结论

气管插管前通过气管喷雾使用10%利多卡因可有效降低POST严重程度和发生率以及插管时的血流动力学反应,突出了其在改善术后患者结局方面的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/2a98c09fea42/12871_2025_3004_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/d31ceab1679c/12871_2025_3004_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/cebb74434d7e/12871_2025_3004_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/8fe268e8a713/12871_2025_3004_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/2a98c09fea42/12871_2025_3004_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/d31ceab1679c/12871_2025_3004_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/cebb74434d7e/12871_2025_3004_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/8fe268e8a713/12871_2025_3004_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ed3/11924844/2a98c09fea42/12871_2025_3004_Fig4_HTML.jpg

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本文引用的文献

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Topical Anaesthesia Using a Soft Mist Spray Device Allows Comfortable Awake Visualisation of the Airway via Self-Videolaryngoscopy in Volunteers.使用软雾喷雾装置进行局部麻醉可使志愿者通过自我视频喉镜检查舒适地清醒观察气道。
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PLoS One. 2020 Aug 10;15(8):e0237174. doi: 10.1371/journal.pone.0237174. eCollection 2020.
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Effect of Intravenous Lidocaine, Dexamethasone, and Their Combination on Postoperative Sore Throat: A Randomized Controlled Trial.静脉利多卡因、地塞米松及其联合应用对术后咽喉痛的影响:一项随机对照试验。
Anesth Analg. 2019 Jul;129(1):220-225. doi: 10.1213/ANE.0000000000003842.
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The effect of lidocaine jelly on a taper-shaped cuff of an endotracheal tube on the postoperative sore throat: a prospective randomized study: A CONSORT compliant article.利多卡因凝胶对气管导管锥形套囊术后咽痛的影响:一项前瞻性随机研究:一篇符合CONSORT声明的文章
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