首页|喉返神经监测的气管导管对腔镜甲状腺手术术后咽喉疼痛的影响

喉返神经监测的气管导管对腔镜甲状腺手术术后咽喉疼痛的影响

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目的 观察喉返神经监测的气管导管对腔镜甲状腺手术术后咽喉疼痛(POST)的影响.方法 选取2022年1月—2022年12月在中国科学技术大学附属第一医院择期行腔镜甲状腺手术的患者116例,美国麻醉医师协会(ASA)分级Ⅰ、Ⅱ级,年龄18~65岁,按随机数字表法分为喉返神经监测的气管导管组(N组)和普通加强气管导管组(R组),每组58例.N组使用喉返神经监测的气管导管,R组使用普通加强气管导管,其他麻醉方法相同.记录两组患者气管导管拔除后0.5、6.0、24.0 h时静息及吞咽时咽喉痛视觉模拟评分法(VAS)疼痛评分,气管导管拔除后24 h内不良反应(POST、声音嘶哑、咳嗽、呛咳、呼吸困难)发生率及补救镇痛情况.结果 与R组比较,N组术后24h内POST发生率较高(P<0.05),声嘶、呛咳发生率较低(均P<0.05),补救镇痛例数较多(P<0.05).N组气管导管拔除后0.5、6.0 h时静息及吞咽时咽喉痛VAS疼痛评分高于R组(均P<0.05).两组患者其余指标差异无统计学意义(均P>0.05)结论 喉返神经监测的气管导管应用于腔镜甲状腺手术可以减少术后声音嘶哑、呛咳的发生,但POST发生率和疼痛程度均高于普通气管导管.
Effect of tracheal catheter monitored by the recurrent laryngeal nerve on postoperative sore throat after endoscopic thyroid surgery
Objective To observe the effect of tracheal catheter monitored by the recurrent laryngeal nerve on postoperative sore throat(POST)after endoscopic thyroid surgery.Methods A total of 116 patients,American Society of Anesthesiologists(ASA)grades Ⅰ or Ⅱ,aged 18-65 years old,who underwent endoscopic thyroid surgery at the First Affiliated Hospital of University of Sci-ence and Technology of China from January 2022 to December 2022,were selected.According to the random number table method,they were divided into two groups(n=58):a recurrent laryngeal nerve-monitored tracheal catheter group(group N)and a commonly rein-forced tracheal catheter group(group R).The recurrent laryngeal nerve-monitored tracheal catheter was used in group N,and commonly reinforced tracheal catheter was used in group R,while other anesthetic methods were the same.The sore throat Visual Analogue Scale(VAS)scores at resting and during swallowing at post-extubation 0.5 h,6.0 h and 24.0 h were recorded.The incidence of adverse reac-tions(POST,hoarseness,cough,choking and dyspnea),and remedial analgesia within 24 h after extubation were recorded in both groups.Results Compared with group R,group N showed increases in the incidence of POST(P<0.05)and decreases in the inci-dence of hoarseness and choking(all P<0.05)within postoperative 24 h,and increases in rescue analgesia use(P<0.05).Compared with group R,group N showed increases in sore throat VAS scores at resting and during swallowing at post-extubation 0.5 h and 6.0 h(all P<0.05).There was no significant difference in other indexes between the two groups(all P>0.05).Conclusions Tracheal cath-eter monitored by the recurrent laryngeal nerve can be applied in endoscopic thyroid surgery,which reduces the incidence of postopera-tive hoarseness and choking,with increases in the incidence of POST and the degree of pain compared with common tracheal catheter.

Endoscopic thyroid surgeryRecurrent laryngeal nerveTracheal intubationPostoperative sore throat

吴菲菲、方军、康芳、李娟

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中国科学技术大学附属第一医院麻醉科,合肥 230001

腔镜甲状腺手术 喉返神经 气管插管 术后咽喉疼痛

中央高校基本科研业务费专项资金安徽省自然科学基金

YD91100020152108085MH323

2024

国际麻醉学与复苏杂志
中华医学会,徐州医学院

国际麻醉学与复苏杂志

CSTPCD
影响因子:0.909
ISSN:1673-4378
年,卷(期):2024.45(8)