Mizoguchi H, Fujiwara M, Takakuwa R, Komeichi Y, Kawamura J, Odashiro M
Department of Anesthesia, Kin-ikyo Chuo Hospital, Sapporo.
Masui. 1996 Sep;45(9):1168-71.
Excessive intracuff pressure due to nitrous oxide diffusion into the cuff can damage the tracheal mucosa. Several endotracheal tubes have been developed (Trachelon gas barrier type tube, Brandt Anaesthesia tube) to limit nitrous oxide-related intracuff pressure increase. We investigated whether the incidence of postoperative sore throat could be reduced by using these tubes. Endotracheal intubation was performed in 37 adult female patients with either a standard tube (group S, n = 14), a gas barrier type tube (group G, n = 11), or a Brandt tube (group B, n = 12). All patients were interviewed 16-30 h postoperatively by anesthesiologist who did not know which tube had been used. The increase of intracuff pressure was significantly lower in group G (7.6 +/- 5.1 mmHg, mean +/- SD) and in group B (3.4 +/- 1.7 mmHg) than that in group S (24.0 +/- 9.5 mmHg). The incidence of postoperative sore throat was not significantly different among the groups, 36% (5/14) in group S, 45% (5/11) in group G, and 33% (4/12) in Group B. This incidence did not correlate with intracuff pressure increase. In conclusion, specially manufactured endotracheal tubes to limit excessive intracuff pressure did not effectively attenuate the incidence of postoperative sore throat in this patient population.
由于氧化亚氮扩散至气管导管套囊内导致套囊内压力过高,可能会损伤气管黏膜。目前已研发出多种气管导管(如Trachelon气体屏障型导管、布兰特麻醉导管)来限制与氧化亚氮相关的套囊内压力升高。我们研究了使用这些导管是否能降低术后咽痛的发生率。对37例成年女性患者进行气管插管,分别使用标准导管(S组,n = 14)、气体屏障型导管(G组,n = 11)或布兰特导管(B组,n = 12)。术后16 - 30小时,由不知道使用何种导管的麻醉医生对所有患者进行访谈。G组(7.6 +/- 5.1 mmHg,均值 +/- 标准差)和B组(3.4 +/- 1.7 mmHg)的套囊内压力升高明显低于S组(24.0 +/- 9.5 mmHg)。各组术后咽痛的发生率无显著差异,S组为36%(5/14),G组为45%(5/11),B组为33%(4/12)。该发生率与套囊内压力升高无关。总之,在该患者群体中,用于限制套囊内压力过高的特制气管导管并不能有效降低术后咽痛的发生率。