中山大学附属第三医院麻醉科,广东 广州,510630
李瑛园,第一作者,E-mail:liyingyuan0608@163.com
纸质出版日期:2024-01-20,
收稿日期:2023-09-13,
录用日期:2023-11-27
扫 描 看 全 文
李瑛园,关健强,黑子清等.双腔气管插管患者术后咽喉痛的危险因素分析[J].中山大学学报(医学科学版),2024,45(01):121-126.
LI Yingyuan,GUAN Jianqiang,HEI Ziqing,et al.Risk Factors for Postoperative Sore Throat in Patients with a Double-lumen Endotracheal Tube[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(01):121-126.
李瑛园,关健强,黑子清等.双腔气管插管患者术后咽喉痛的危险因素分析[J].中山大学学报(医学科学版),2024,45(01):121-126. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240004.002.
LI Yingyuan,GUAN Jianqiang,HEI Ziqing,et al.Risk Factors for Postoperative Sore Throat in Patients with a Double-lumen Endotracheal Tube[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(01):121-126. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240004.002.
目的
2
探讨拔管力等因素是否是双腔气管插管术后咽喉痛的危险因素。
方法
2
这是一项随机对照试验的事后分析。本研究收集18~65岁,ASAI-Ⅲ级的双腔气管插管患者围术期资料,记录性别、年龄、吸烟史、导管直径、导管留置时间、舒芬太尼用量、是否使用氟比洛芬酯、是否拔管时呛咳等。拔管时使用测力计测量拔除导管所需的力。根据术后是否发生咽喉痛分为咽喉痛组和无咽喉痛组。对两组资料进行组间比较和多因素logistic回归分析,筛选术后咽喉痛的危险因素。使用ROC曲线预测危险因素的预测效应。
结果
2
最终纳入163例患者,拔管后30 min有74例(45.4%)患者发生术后咽喉痛,89例(54.6%)患者未发生术后咽喉痛。多因素logistic回归分析结果显示女性[OR95%CI=3.83(1.73,8.50),
P
=0.000 1]和拔管力增大[OR95%CI=1.78(1.45,2.20),
P
<0.001]是术后咽喉痛的独立危险因素。拔管力预测术后咽喉痛的AUC曲线为0.773[95%CI(0.701,0.846),
P
<0.001] ;当约登指数为0.447时,拔管力的最佳临界点是13N。
结论
2
女性和拔管力是双腔气管插管全身麻醉术后咽喉痛的独立危险因素。
Objective
2
To investigate risk factors for postoperative sore throat in patients with double-lumen endotracheal intubation.
Methods
2
The data used in this post-hoc analysis were prospectively collected from a randomized, controlled trial. Age from 18 to 65 years old, ASAI-Ⅲ patients undergoing general anesthesia with a double-lumen endotracheal tube were enrolled. The perioperative data collected retrospectively were as follows: gender, age, smoking history, endotracheal tube diameter, duration of endotracheal tube, dose of Sufentanil, use of Flurbiprofen Axetil, cough after extubation, etc..Dynamometer was applied to assess extubation force. According to occurrence of postoperative sore throat, patients were divided into two groups: those who experienced sore throats and those who did not. Comparative analysis and multivariate logistic regression analysis were performed to screen the risk factors. ROC curve was used for predicting the predictive value of risk factors.
Results
2
Among the 163 patients , 74 (45.4%) had postoperative sore throat
vs
89 (54.6%) not had. Multivariate logistic regression showed female [OR95%CI=3.83(1.73, 8.50),
P
=0.000 1] and extubation force [OR95%CI=1.78(1.45, 2.17),
P
<0.001] were independent risk factors for postoperative sore throat. AUC value showed the extubation force was 0.773[95%CI(0.701, 0.846),
P
<0.001]. Youden index was 0.447, and the cut-off valve of extubation force was 13N.
Conclusion
2
Female and extubation force were risk factors for sore throat in patients with double lumen endotracheal intubation.
双腔气管插管术后咽喉痛危险因素气管拔管拔管力全身麻醉
double-lumen endotracheal tubepostoperative sore throatrisk factortracheal extubationextubation forcegeneral anesthesia
Bi X, Wen J, Chen Q, et al. Effects of thermal softening of double-lumen endobronchial tubes on the prevention of postoperative sore throat in smokers: a randomized controlled trial [J]. J Cardiothorac Vasc Anesth, 2022, 36(8 Pt B): 3109-3113.
Lehma M, Monte K, Barach P, et al. Postoperative patient complaints: a prospective interview study of 12,276 patients [J]. J Clin Anesth, 2010, 22(1): 13-21.
Look X, Mok MUS, Tay YS, et al. How do Singapore patients view post-anaesthesia adverse outcomes? A single-centre willingness-to-pay study [J]. Singapore Med J, 2018, 59(5): 264-270.
Cho HY, Yang SM, Jung CW, et al. A randomised controlled trial of 7.5-mm and 7.0-mm tracheal tubes vs. 6.5-mm and 6.0-mm tracheal tubes for men and women during laparoscopic surgery [J]. Anaesthesia, 2022, 77(1): 54-58.
Hailu S, Shiferaw A, Regasa T, et al. Incidence of postoperative sore throat and associated factors among pediatric patients undergoing surgery under general anesthesia at Hawassa University Comprehensive Specialized Hospital, a prospective cohort study [J]. Int J Gen Med, 2023, 16: 589-598.
Zheng ZP, Tang SL, Fu SL, et al. Identifying the risk factors for postoperative sore throat after endotracheal intubation for oral and maxillofacial surgery [J]. Ther Clin Risk Manag, 2023, 19: 163-170.
Christiansen P, Pedersen CH, Selter H, et al. How does tube size affect patients' experiences of postoperative sore throat and hoarseness? a randomised controlled blinded study [J]. J Clin Med, 2021, 10(24):5846-5854.
Sakkanan NV, Elakkumanan LB. Extubation parameters and postoperative sore throat [J]. Anesth Analg, 2020, 130(2): 42-43.
Kusunoki T, Sawai T, Komasawa N, et al. Correlation between extraction force during tracheal intubation stylet removal and postoperative sore throat [J]. J Clin Anesth, 2016, 33: 37-40.
Mihara R, Komasawa N, Matsunami S, et al. The effect of extraction angle on endotracheal tube extubation force: simulation and randomized clinical trial [J]. J Int Med Res, 2015, 43(5): 653-660.
Kido H, Komasawa N, Imajo Y, et al. Evaluation of double-lumen endotracheal tube extubation force by extraction angle: a prospective randomized clinical trial [J]. J Clin Anesth, 2016, 29: 40-45.
Seo JH, Kwon TK, Jeon Y, et al. Comparison of techniques for double-lumen endobronchial intubation: 90 degrees or 180 degrees rotation during advancement through the glottis [J]. Br J Anaesth, 2013, 111(5): 812-817.
Kim H, Kim J E, Kim Y, et al. Slow advancement of the endotracheal tube during fiberoptic-guided tracheal intubation reduces the severity of postoperative sore throat [J]. Sci Rep, 2023, 13(1):7709-7715.
彭婷, 罗爱林, 韩东吉. 甲状腺手术患者术后咽喉部干痛的相关影响因素分析 [J]. 临床麻醉学, 2017, 33: 576-578.
Peng T, Luo AL, Han DJ. Related factor analysis on sore throat and pharyngeal xeransis during thyroid surgery[J]. J clin anesthesiol, 2017, 33: 576-578.
曲海霞, 李洁. 利多卡因联合布地奈德雾化吸入对双腔支气管插管患者术后咽喉痛的影响 [J]. 中国药物与临床麻醉, 2020, 20: 3777-3779.
Qu HX, Li J. Effect of lidocaine combined with budesonide aerosol inhalation on postoperative sore throat in patients with double-lumen bronchial intubation[J]. Chinese Remedies & Clinics, 2020, 20: 3777-3779.
郭月, 陈红, 胡曼,等. 双腔气管插管全身麻醉手术患者术后咽喉痛现状及影响因素分析 [J]. 中国现代护理杂志, 2019, 27: 4650-4654.
Guo Y, Chen H, Hu M, et al. Current status and influencing factors of postoperative sore throat in patients undergoing general anesthesia with double-lumen endotracheal intubation[J]. J Mod NursChin, 2019, 27:4650-4654
Aqil M, Khan MU, Mansoor S, et al. Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope [J]. BMC Anesthesiol, 2017, 17(1): 127-135.
Jiang J, Wang Z, Xu Q, et al. Development of a nomogram for prediction of postoperative sore throat in patients under general anaesthesia: a single-centre, prospective, observational study [J]. BMJ Open, 2022, 12(5): 84-90.
Laurenbacher S, Peters JH, Heesen M, et al. Age changes in pain perception: a systematic-review and meta-analysis of age effects on pain and tolerance thresholds [J]. Neurosci Biobehav Rev, 2017, 75: 104-113.
Myles PS, Hunt JO, Moloney JT. Postoperative ‘minor’ complications comparison between men and women [J]. Anaesthesia, 1997, 52: 300-306.
Brodsky MB, Akst LM, Jedlanek E, et al. Laryngeal injury and upper airway symptoms after endotracheal intubation during surgery: a systematic review and meta-analysis [J]. Anesth Analg, 2021, 132(4): 1023-1032.
Chandler M. Tracheal intubation and sore throat: a mechanical explanation [J]. Anaesthesia, 2002, 57: 155-161.
Nishino T. Physiological and pathophysiological implications of upper airway reflexes in Humans [J]. Jpn J Physiol, 2000, 50: 3-14.
0
浏览量
13
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构