Friedman P G, Rosenberg M K, Lebenbom-Mansour M
Department of Anesthesiology, Sinai Hospital, Farmington Hills, Michigan 48334, USA.
Anesth Analg. 1997 Sep;85(3):578-82. doi: 10.1097/00000539-199709000-00017.
Endotracheal intubation can produce postoperative sore throat and hoarseness, as well as changes in cardiovascular variables. A major goal of ambulatory surgery is the prompt return of patients to their daily activities. Postoperative sore throat may impede this and may decrease patient satisfaction with their anesthetic and surgical experience. We conducted a prospective, randomized study in 40 outpatients having lower extremity arthroscopies to compare the effects of direct laryngoscopy and light wand intubation on cardiovascular changes, sore throat, hoarseness, and dysphagia. Subjects were randomly assigned to either Group A (endotracheal intubation by rigid laryngoscopy) or Group B (endotracheal intubation with a light wand). A standardized anesthetic technique was used. Heart rate and blood pressure were recorded before induction, after induction but before endotracheal intubation, and at 1-min intervals for the first 5 min after intubation. Sixteen to twenty-four hours postoperatively, the incidence and severity of sore throat, hoarseness, and dysphagia was assessed by a follow-up phone call. This study demonstrated no clinically significant difference in cardiovascular variables between the two techniques. Patients had a significantly lower incidence and severity of sore throat, hoarseness, and dysphagia when a light wand was used for intubation. In conclusion, this study suggests that light wand intubation may decrease the incidence and severity of postoperative sore throat, hoarseness, and dysphagia, thereby potentially increasing satisfaction in ambulatory surgical patients.
This prospective, randomized study found that the incidence and severity of postoperative sore throat, hoarseness, and difficulty in swallowing among ambulatory surgical patients is more frequent when they are endotracheally intubated with a rigid laryngoscope than with a light wand. The authors, therefore, recommend more frequent use of the light wand for endotracheal intubation.
气管插管可导致术后咽痛、声音嘶哑以及心血管参数变化。门诊手术的一个主要目标是让患者迅速恢复日常活动。术后咽痛可能会妨碍这一目标的实现，并可能降低患者对麻醉和手术体验的满意度。我们对40例接受下肢关节镜检查的门诊患者进行了一项前瞻性随机研究，以比较直接喉镜检查和光棒插管对心血管变化、咽痛、声音嘶哑和吞咽困难的影响。受试者被随机分为A组（硬喉镜气管插管）或B组（光棒气管插管）。采用标准化麻醉技术。记录诱导前、诱导后但气管插管前以及插管后前5分钟每隔1分钟的心率和血压。术后16至24小时，通过随访电话评估咽痛、声音嘶哑和吞咽困难的发生率及严重程度。本研究表明，两种技术在心血管参数方面无临床显著差异。使用光棒插管时，患者咽痛、声音嘶哑和吞咽困难的发生率及严重程度显著更低。总之，本研究提示光棒插管可能会降低术后咽痛、声音嘶哑和吞咽困难的发生率及严重程度，从而可能提高门诊手术患者的满意度。
这项前瞻性随机研究发现，门诊手术患者使用硬喉镜进行气管插管时，术后咽痛、声音嘶哑和吞咽困难的发生率及严重程度比使用光棒插管时更高。因此，作者建议更频繁地使用光棒进行气管插管。
