氧化亚氮和手术体位对气管导管套囊压力、术后声音嘶哑及咽痛的影响：一项双盲临床试验
The effects of nitrous oxide and surgical position on endotracheal tube cuff pressure, post operative hoarseness, and sore throat; a double-blind clinical trial.
作者信息
Chaichi-Nosrati Gholamhassann, Moshiri Esmail, Modir Hesameddin, Mohammadi Alireza
机构信息
Department of Anesthesiology and Critical Care, Students Research Committee, Arak University of Medical Sciences, Arak, Iran.
Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran.
出版信息
Ann Thorac Med. 2025 Jul-Sep;20(3):153-159. doi: 10.4103/atm.atm_204_24. Epub 2025 Jun 23.
BACKGROUND
The aim of this study was to evaluate the effects of nitrous oxide (NO) and surgical position on endotracheal tube cuff (ETC) pressure, hoarseness, and sore throat (ST) after surgery under general anesthesia (GA).
METHODS
This double-blind clinical trial was conducted on 212 candidates for surgery under GA. They were randomly allocated to four groups, namely a supine position group (Group S), a prone position group (Group P), a supine position and NO group (Group SN), and a prone position and NO group (Group PN). ST and hoarseness were assessed at recovery and 2, 4, 8, 12, and 24 h after surgery using a visual analog scale and a mild-to-severe scoring system, respectively. ETC pressure was also measured at 15, 30, 60, 90, and 120 min after surgery onset using an Ambu cuff pressure gauge. Moreover, the mean intraoperative propofol concentration was documented. The data were analyzed at a significance level of <0.05 and using the SPSS software (version 20.0).
RESULTS
There was no significant difference among groups regarding surgery duration ( = 0.998), whereas ST and ETC pressure in Groups S and P were significantly less than Groups SN and PN ( = 0.001). Moreover, ST and ETC pressure in Group S were significantly less than the other groups ( = 0.001). None of the participants in Groups S and P had hoarseness, and there was a significant difference among the four groups regarding the frequency of hoarseness ( = 0.001). Moreover, none of the participants in Group SN needed postoperative analgesic, and there was no significant difference between Groups S and regarding postoperative analgesic use ( = 0.998). Intraoperative propofol use in Group SN was significantly less than the other groups ( = 0.001).
CONCLUSION
ETC pressure should periodically be monitored and adjusted during lengthy surgeries in prone position and NO anesthesia to prevent postoperative ST and hoarseness.
背景
本研究旨在评估一氧化二氮（NO）和手术体位对全身麻醉（GA）下手术后气管导管套囊（ETC）压力、声音嘶哑和咽痛（ST）的影响。
方法
本双盲临床试验对212例GA下手术的候选患者进行。他们被随机分为四组，即仰卧位组（S组）、俯卧位组（P组）、仰卧位加NO组（SN组）和俯卧位加NO组（PN组）。分别使用视觉模拟量表和轻至重度评分系统在术后恢复时以及术后2、4、8、12和24小时评估ST和声音嘶哑情况。还在手术开始后15、30、60、90和120分钟使用Ambu袖带压力计测量ETC压力。此外，记录术中丙泊酚的平均浓度。数据以<0.05的显著性水平并使用SPSS软件（版本20.0）进行分析。
结果
各组手术持续时间无显著差异（ = 0.998），而S组和P组的ST和ETC压力显著低于SN组和PN组（ = 0.001）。此外，S组的ST和ETC压力显著低于其他组（ = 0.001）。S组和P组的参与者均无声音嘶哑，四组之间声音嘶哑的发生率有显著差异（ = 0.001）。此外，SN组的参与者均无需术后镇痛，S组和[此处原文可能有误，缺失组名]在术后镇痛使用方面无显著差异（ = 0.998）。SN组术中丙泊酚的使用量显著低于其他组（ = 0.001）。
结论
在长时间俯卧位和NO麻醉手术期间，应定期监测和调整ETC压力，以预防术后ST和声音嘶哑。
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