不同气管导管润滑剂对全身麻醉患者术后咽喉痛的影响  

Effect of different lubricants applied over tracheal tube on postoperative sore throat in patients under general anesthesia

作　　者：刘海恋[1] 黄绍强[1] 王美华[1] 

机构地区：[1]复旦大学附属妇产科医院麻醉科,上海200090

出　　处：《上海医学》2014年第2期113-115,共3页Shanghai Medical Journal

摘　　要：目的探讨不同气管导管润滑剂对全身麻醉患者术后咽喉痛的影响。方法本研究为前瞻性的随机、双盲、对照研究，选择150例择期在气管插管全身麻醉下行妇科腹腔镜手术的患者，年龄20～60岁，体重50-70kg，美国麻醉医师学会（ASA）分级I或Ⅱ级，手术时间1～3h。麻醉前按照随机数字表法分组将一次性气管导管头端分别涂以0．9％氯化钠溶液、石蜡油或1％丁卡因凝胶，实施标准的全身麻醉和镇痛方案。于拔除气管导管后10min、术后1h、术后24h由不知道分组情况的观察者记录患者咽喉痛和术后声音嘶哑的发生情况。结果丁卡因凝胶组术后各时间点的咽喉痛发生率均显著低于0．9％氯化钠溶液组和石蜡油组（P值均〈0．05），而0．9％氯化钠溶液组与石蜡油组间的差异均无统计学意义（P值均〉0．05）。3组间术后各时间点的咽喉痛分级的差异均有统计学意义（P值均〈0．05），丁卡因凝胶组的咽喉痛严重程度最轻。3组间术后1h声音嘶哑发生率的差异无统计学意义（P=0．136），术后24h时3组均无声音嘶哑的患者。结论与0．9％氯化钠溶液和石蜡油相比，以丁卡因凝胶润滑气管导管可以明显降低气管插管全身麻醉术后咽喉痛的发生率和严重程度。Objective To investigate the effects of different lubricants applied over tracheal tube on postoperative sore throat after general anesthesia. Methods One hundred and fifty patients （aged 20- 60 years, weighing 50-70 kg, American Society of Anesthesiologists grade I or IT ） undergoing elective gynecological laparoscopic surgery under standard general anaesthesia were enrolled in this prospective, double-blind and controlled study and randomized into three groups： paraffin oil, tetracaine jelly, and normal saline groups. 0.9% sodium chloride solution, paraffin oil and 1% tetracaine jelly were applied before anesthesia on the head of tracheal tube, respectively. The surgery lasted for 1 -3 h. A blinded observer interviewed all patients on postoperative sore throat and hoarseness at 10 min, 1 h and 24 h after operation. Results The incidences and severity of sore throat in the tetracaine group were significantly lower than those in the other two groups after surgery （all P〈0. 05）, while there was no significant difference between the saline group and the paraffin oil group （all P〉0. 05）. There was no significant difference in the incidences of hoarseness at 1 h after operation between the three groups （ P= 0.136）. No patient suffered from hoarseness at 24 h after surgery. Conclusion Compared with normal saline and paraffin oil, application of tetracaine jelly on the tracheal tube can significantly decrease the incidence and severity of postoperative sore throat after general anesthesia.

关 键 词：气管插管 咽喉疼痛 丁卡因 

分 类 号：R614[医药卫生—麻醉学]