颌面手术咽后壁纱布填塞及手术部位对术后咽喉痛的影响
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摘要
目的对比观察颌面手术咽后壁纱布填塞及手术部位对术后咽喉痛的影响。方法选取2017年9月至2018年5月中国医学科学院整形外科医院70例美国麻醉医师协会(American Society of Anesthesiologist, ASA)分级Ⅰ级的颌面手术患者,随机分为A组(无咽后壁纱布组,35例)和B组(咽后壁纱布组,35例),处理方式为全身麻醉后有或无咽后壁纱布填塞,观察术后1 h、4 h、12 h、24 h患者咽喉痛情况及术区在口裂上、下时的咽喉痛情况。结果术后1 h、4 h、12h、24 h,A组咽喉痛的发生率分别为80.0%、91.4%、91.4%、82.8%,B组发生率分别为68.6%、88.6%、88.6%、80.0%,组间比较差异无统计学意义(P> 0.05)。术区仅涉及口裂以上者,术后咽喉痛的总体发生率为61.1%;术区涉及口裂下者,术后咽喉痛的发生率为100%,差异有统计学意义(P <0.001)。结论颌面手术是否应用咽后壁纱布,对术后咽喉痛发生率可能无影响,手术损伤可能是颌面手术咽喉痛的主要原因之一。
Objective To compare the effects of pharyngeal packing and maxillofacial surgery site on postoperative sore throat. Methods Seventy patients with ASA grade I plastic surgery in Plastic Surgery Hospital from September 2017 to May 2018 were randomly divided into two groups: group A(none pharyngeal packing group, n=35) and group B(pharyngeal packing group, n=35). After rapid induction of anesthesia, patients were given the pharyngeal packing or not. Cormaoch-Lehane classification of laryngoscope exposure during intubation, number of intubations, total time from intubation to extubation, postoperative throat pain 1 h, 4 h, 12 h, 24 h were recorded. Results The incidences of postoperative throat pain in group A and group B were 80.0%, 91.4%, 91.4%, 82.8%, and 68.6%, 88.6%, 88.6%, 80.0% respectively, at 1 h, 4 h, 12 h, 24 h after operation. There were no significant differences in the incidence of postoperative throat pain between the two groups(P > 0.05). The overall incidence of postoperative sore throat was 61.1% at the site of operation above the cleft mouth, and100% at the site of operation involving sore throat after the cleft mouth(P < 0.001). Conclusions Whether to apply pharyngeal packing or not may not impact the incidence of postoperative sore throat. The surgical may be one of the main causes of pharyngeal and laryngeal pain in maxillofacial surgery.
Objective To compare the effects of pharyngeal packing and maxillofacial surgery site on postoperative sore throat. Methods Seventy patients with ASA grade I plastic surgery in Plastic Surgery Hospital from September 2017 to May 2018 were randomly divided into two groups: group A(none pharyngeal packing group, n=35) and group B(pharyngeal packing group, n=35). After rapid induction of anesthesia, patients were given the pharyngeal packing or not. Cormaoch-Lehane classification of laryngoscope exposure during intubation, number of intubations, total time from intubation to extubation, postoperative throat pain 1 h, 4 h, 12 h, 24 h were recorded. Results The incidences of postoperative throat pain in group A and group B were 80.0%, 91.4%, 91.4%, 82.8%, and 68.6%, 88.6%, 88.6%, 80.0% respectively, at 1 h, 4 h, 12 h, 24 h after operation. There were no significant differences in the incidence of postoperative throat pain between the two groups(P > 0.05). The overall incidence of postoperative sore throat was 61.1% at the site of operation above the cleft mouth, and100% at the site of operation involving sore throat after the cleft mouth(P < 0.001). Conclusions Whether to apply pharyngeal packing or not may not impact the incidence of postoperative sore throat. The surgical may be one of the main causes of pharyngeal and laryngeal pain in maxillofacial surgery.
引文
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[7]Fine J,Kaltman S,Bianco M.Prevention of sore throat after nasotracheal intubation[J].J Oral Maxillofac Surg,1988,46:946-947.2018-11-02
[2]安洁,邓晓明.气管插管术后咽喉痛的预防和治疗[J].医学综述,2018,24:2807-2811.
[3]Sumathi PA,Shenoy T,Ambareesha M,et al.Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat,cough,and hoarseness of voice[J].Br J Anaesth,2008,100:215-218.
[4]El-Boghdadly K,Bailey CR,Wiles MD.Postoperative sore throat:a systematic review[J].Anaesthesia,2016,71:706-717.
[5]Tay JY,Tan WK,Chen FG,et al.Postoperative sore throat after routine oral surgery:influence of the presence of a pharyngeal pack[J].Br J Oral Maxillofac Surg,2002,40:60-63.
[6]Al-Lami A,Amonoo-Kuofi K,Kulloo P,et al.A study evaluating the effects of throat packs during nasal surgery:a randomised controlled trial[J].Eur Arch Otorhinolaryngol,2017,274:3109-3114.
[7]Fine J,Kaltman S,Bianco M.Prevention of sore throat after nasotracheal intubation[J].J Oral Maxillofac Surg,1988,46:946-947.2018-11-02