袖带内生理盐水、地塞米松和氯胺酮预防术后喉咙痛的效果比较：一项随机对照试验。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology Pub Date : 2025-06-13 DOI:10.1016/j.bjane.2025.844651

Arun Mukesh , Ankur Sharma , Priyabrat Karan , Darshna Rathod , Shilpa Goyal , Kamlesh Kumari , Manbir Kaur , Tanvi Meshram , Pradeep Bhatia

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引用次数: 0

摘要

背景：术后喉咙痛（POST）可能导致患者不满和痛苦，这可能会延迟出院。已经探索了各种药理学和非药理学方法，但有效的技术仍然难以捉摸。本研究评估袖内地塞米松、氯胺酮和生理盐水对缓解后症状的影响。方法：在这项随机对照试验中，纳入了405例18-60岁的成人患者，他们在全身麻醉下接受盆腔腹腔镜短时间手术1-3小时，需要气管插管。患者随机分为N组（袖带内注射生理盐水）、D组（袖带内注射地塞米松）和K组（袖带内注射氯胺酮）。本研究的主要结局是拔管后2、6、12和24小时的POST发生率和严重程度。次要结局是不同时间间隔的术后声音嘶哑和术后咳嗽的发生率和严重程度。结果：2 h时，D组无POST症状患者（92.59%）多于K组（74.07%）和N组（67.41%）（p < 0.0001）。同样，D组患者术后2小时无声音嘶哑（93.33%）和术后咳嗽（93.33%）症状较多。此外，D组在不同的时间间隔内均表现出最低的POST发生率、术后声音嘶哑和术后咳嗽。结论：在术后早期，袖内地塞米松似乎是缓解POST症状、术后声音嘶哑和术后咳嗽的有利干预措施。临床试验注册号：CTRI/2022/08/044664。

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Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: a randomized controlled trial

Background

Postoperative Sore Throat (POST) may result in patient dissatisfaction and distress, which could possibly delay discharge. Various pharmacological and non-pharmacological approaches have been explored, yet effective techniques remain elusive. This research evaluates the impact of intra-cuff Dexamethasone, Ketamine, and normal saline on alleviating POST symptoms.

Methods

In this randomized controlled trial, 405 adult patients aged 18‒60 years undergoing short pelvic laparoscopic surgeries under general anesthesia for 1‒3 h requiring endotracheal intubation were enrolled. Patients were randomized into Group N (intra-cuff normal saline), Group D (intra-cuff Dexamethasone), and Group K (intra-cuff Ketamine). The primary outcome of this study was the incidence and severity of POST at 2, 6, 12, and 24 hours after extubation. Secondary outcomes were the incidence and severity of postoperative hoarseness of voice and postoperative cough at various time intervals.

Results

There were more patients in Group D without symptoms of POST (92.59 %) than in Group K (74.07 %) and Group N (67.41 %) (p < 0.0001) at 2 h. Similarly, more patients had no symptoms of postoperative hoarseness of voice (93.33 %) and postoperative cough (93.33 %) in Group D at 2 h. Furthermore, Group D consistently exhibited the lowest incidence of POST, postoperative hoarseness of voice, and postoperative cough at various time intervals.

Conclusions

Intra-cuff Dexamethasone appears to be a favourable intervention for symptom alleviation of POST, postoperative hoarseness of voice, and postoperative cough during the early postoperative period.