Effect of peri-intubation non-pharmacological interventions on postoperative laryngeal symptoms: A systematic review with meta-analysis and meta-regression

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing Pub Date : 2024-06-10 DOI:10.1016/j.iccn.2024.103728

Sevilay Senol Celik , Athanasios Chalkias , Seda Sariköse , Hande Nur Arslan , Ali Bahramifar , Farshid Rahimi-Bashar , Ali Ait Hssain , Saeed Hashemi , Amir Vahedian-Azimi

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引用次数: 0

Abstract

Objectives

To evaluate the effectiveness of peri-intubation non-pharmacological interventions in reducing postoperative sore throat (POST), cough (PEC), and hoarseness in surgical patients.

Design

A systematic review with meta-analysis and meta-regression.

Setting

Elective surgery under general anesthesia in operating rooms.

Main Outcome Measures

Evaluate the impact of non-pharmacological interventions, including pre-intubation (gargling with Sodium Azulene Sulfonate, licorice, or using Strepsils tablets of honey and lemon lozenge), during-intubation (inflating the TT cuff with normal saline and softening the ETT cuff with warm normal saline), and post-intubation (cold vapor therapy, gargling with honey lemon water, and using green tea gargle), on the occurrence of POST, PEC, and hoarseness.

Results

Nineteen trials with 2,136 participants were included. Pre-intubation intervention significantly reduced POST immediately after extubation (n = 861; OR: 0.28, 95 % CI: 0.20–0.38, P < 0.001), and 24 h post-extubation (n = 1006; OR: 0.21, 95 % CI: 0.16–0.28, P < 0.001). During-intubation intervention did not show significant effects on POST. Pre-intubation intervention also reduced POST-associated pain score at 24 h post-extubation (n = 440; MD: −0.50, 95 % CI: −0.81 to −0.18, P < 0.001). Post-intubation interventions were effective in reducing POST-associated pain scores at different time points post-extubation (P < 0.05). Pre-intubation intervention significantly reduced PEC (OR: 0.13, 95 % CI: 0.02–0.70, P = 0.02) and hoarseness (OR: 0.36, 95 %CI: 0.15–0.86, P = 0.02) at 24 h post-extubation. However, during-intubation interventions did not reduce hoarseness at 24 h post-extubation.

Conclusion

Pre-intubation non-pharmacological interventions were found to be the most effective in reducing the incidence and severity of POST, PEC, and hoarseness.

Implications for Clinical Practice

Implementing pre-intubation non-pharmacological interventions can be beneficial for bedside nurses and healthcare professionals in reducing postoperative complications and nurses can contribute to improving patient comfort and recovery outcomes following surgery.

Systematic Review Protocol

The protocol was registered in the PROSPERO international prospective register of systematic reviews on 2 January 2024 (CRD42023492813).

查看原文本刊更多论文

插管周围非药物干预对术后喉部症状的影响：荟萃分析和荟萃回归系统综述

目的评估插管前非药物干预对减轻手术患者术后咽喉痛（POST）、咳嗽（PEC）和声音嘶哑的效果。主要结果测量评估非药物干预措施的影响，包括插管前（用偶氮苯磺酸钠、甘草漱口或使用Strepsils蜂蜜片和柠檬片）、插管期间（用生理盐水给 TT 袖带充气，用温热的生理盐水软化 ETT 袖带）和插管后（冷蒸汽疗法、用蜂蜜柠檬水漱口和使用绿茶漱口水）对 POST、PEC 和声音嘶哑发生率的影响。结果 19 项试验共纳入 2,136 名参与者。插管前干预明显降低了拔管后即刻（n = 861；OR：0.28，95 % CI：0.20-0.38，P < 0.001）和拔管后 24 小时（n = 1006；OR：0.21，95 % CI：0.16-0.28，P < 0.001）的 POST。插管期间的干预对插管后24小时无明显影响。插管前干预也降低了拔管后24小时的POST相关疼痛评分（n = 440；MD：-0.50，95 % CI：-0.81至-0.18，P < 0.001）。插管后干预能有效降低插管后不同时间点的插管后相关疼痛评分（P < 0.05）。插管前干预可明显降低插管后 24 小时的 PEC（OR：0.13，95 %CI：0.02-0.70，P = 0.02）和声音嘶哑（OR：0.36，95 %CI：0.15-0.86，P = 0.02）。结论发现插管前非药物干预对降低 POST、PEC 和声音嘶哑的发生率和严重程度最为有效。对临床实践的启示实施插管前非药物干预措施有利于床旁护士和医护人员减少术后并发症，护士可以为改善患者舒适度和术后恢复效果做出贡献。系统综述协议该协议于2024年1月2日在PROSPERO国际系统综述前瞻性注册中心注册（CRD42023492813）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.