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比较袖带内注入生理盐水、地塞米松或氯胺酮预防术后咽痛的效果:一项随机对照试验。

Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: a randomized controlled trial.

作者信息

Mukesh Arun, Sharma Ankur, Karan Priyabrat, Rathod Darshna, Goyal Shilpa, Kumari Kamlesh, Kaur Manbir, Meshram Tanvi, Bhatia Pradeep

机构信息

All India Institute of Medical Sciences (AIIMS), Department of Anesthesiology & Critical Care, Jodhpur, India.

All India Institute of Medical Sciences (AIIMS), Department of Trauma & Emergency (Anesthesiology & Critical Care), Jodhpur, India.

出版信息

Braz J Anesthesiol. 2025 Jun 13;75(5):844651. doi: 10.1016/j.bjane.2025.844651.

Abstract

BACKGROUND

Postoperative Sore Throat (POST) may result in patient dissatisfaction and distress, which could possibly delay discharge. Various pharmacological and non-pharmacological approaches have been explored, yet effective techniques remain elusive. This research evaluates the impact of intra-cuff Dexamethasone, Ketamine, and normal saline on alleviating POST symptoms.

METHODS

In this randomized controlled trial, 405 adult patients aged 18‒60 years undergoing short pelvic laparoscopic surgeries under general anesthesia for 1‒3 h requiring endotracheal intubation were enrolled. Patients were randomized into Group N (intra-cuff normal saline), Group D (intra-cuff Dexamethasone), and Group K (intra-cuff Ketamine). The primary outcome of this study was the incidence and severity of POST at 2, 6, 12, and 24 hours after extubation. Secondary outcomes were the incidence and severity of postoperative hoarseness of voice and postoperative cough at various time intervals.

RESULTS

There were more patients in Group D without symptoms of POST (92.59 %) than in Group K (74.07 %) and Group N (67.41 %) (p < 0.0001) at 2 h. Similarly, more patients had no symptoms of postoperative hoarseness of voice (93.33 %) and postoperative cough (93.33 %) in Group D at 2 h. Furthermore, Group D consistently exhibited the lowest incidence of POST, postoperative hoarseness of voice, and postoperative cough at various time intervals.

CONCLUSIONS

Intra-cuff Dexamethasone appears to be a favourable intervention for symptom alleviation of POST, postoperative hoarseness of voice, and postoperative cough during the early postoperative period.

CLINICAL TRIAL REGISTRY NUMBER

CTRI/2022/08/044,664.

摘要

背景

术后咽痛(POST)可能导致患者不满和痛苦,这可能会延迟出院。人们已经探索了各种药物和非药物方法,但有效的技术仍然难以捉摸。本研究评估了气管导管套囊内注入地塞米松、氯胺酮和生理盐水对减轻POST症状的影响。

方法

在这项随机对照试验中,纳入了405例年龄在18至60岁之间、接受全身麻醉下1至3小时的短盆腔腹腔镜手术且需要气管插管的成年患者。患者被随机分为N组(气管导管套囊内注入生理盐水)、D组(气管导管套囊内注入地塞米松)和K组(气管导管套囊内注入氯胺酮)。本研究的主要结局是拔管后2、6、12和24小时POST的发生率和严重程度。次要结局是不同时间间隔术后声音嘶哑和术后咳嗽的发生率和严重程度。

结果

在2小时时,D组中没有POST症状的患者(92.59%)比K组(74.07%)和N组(67.41%)更多(p<0.0001)。同样,在2小时时,D组中更多患者没有术后声音嘶哑症状(93.33%)和术后咳嗽症状(93.33%)。此外,在各个时间间隔,D组的POST、术后声音嘶哑和术后咳嗽的发生率始终最低。

结论

气管导管套囊内注入地塞米松似乎是术后早期减轻POST、术后声音嘶哑和术后咳嗽症状的一种有利干预措施。

临床试验注册号

CTRI/2022/08/044,664。

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