【原】?外用氯己定-芐達(dá)明噴霧劑對喉罩氣道應(yīng)用的影響

罌粟花anesthGH 2022-04-29

展開全文

外用氯己定-芐達(dá)明噴霧劑對喉罩氣道應(yīng)用的影響

貴州醫(yī)科大學(xué) 麻醉與心臟電生理課題組

翻譯：陳銳編輯：張中偉審校：曹瑩

背景

喉罩氣道 (LMA) 的使用在麻醉實踐中非常普遍。插入 LMA 時可能會出現(xiàn)喉嚨痛、耳痛、聲音嘶啞和吞咽困難。本研究的主要目的是描述局部應(yīng)用葡萄糖酸氯己定和鹽酸芐達(dá)明（Kloroben ^?口腔噴霧劑，規(guī)格：30 毫升）噴霧對因使用 LMA 引起的術(shù)后喉嚨痛的影響。次要目的是評估耳痛、吞咽困難、惡心和嘔吐以及 LMA 插入引起的血流動力學(xué)反應(yīng)以及 LMA 移除期間咳嗽、咬牙、去飽和和喉部痙攣的發(fā)生率。

方法

在獲得機構(gòu)倫理委員會批準(zhǔn)和書面知情同意書（參考編號 29/15）后，共納入 100 名成年患者。C組于術(shù)前15 min鼻咽部噴灑葡萄糖酸氯己定鹽酸芐達(dá)明4噴次。在S組中，使用相同的方案應(yīng)用 0.9% 生理鹽水。

結(jié)果

兩組比較時，S組患者術(shù)后1小時出現(xiàn)咳嗽、咽痛和吞咽困難的患者較多（P<0.05），但兩組在術(shù)后6、12、24小時的發(fā)生率差異無統(tǒng)計學(xué)意義(P>0.05)。在所有測量時間，兩組的惡心、嘔吐和耳痛發(fā)生率相似（P>0.05）。

結(jié)論

喉罩插入前在局部應(yīng)用鹽酸芐達(dá)明和葡萄糖酸氯己定噴霧劑可降低與 LMA 使用相關(guān)的喉嚨痛、咳嗽和吞咽困難的發(fā)生率。

原始文獻(xiàn)來源

Altinsoy S, ütebey G, Kavak Akelma F, Ergil J. The effects of topical chlorhexidine-benzydamine spray on laryngeal mask airway application. Minerva Anestesiol 2020;86:277-85.

英文原文

The effects of topical chlorhexidine-benzydamine spray on laryngeal mask airway application

ABSTRACT

BACKGROUND: Laryngeal mask airway (LMA) use is very common during anesthesia practice. Sore throat, earache, hoarseness and swallowing difficulties may occur on LMA insertion. The primary aim of this study was to describe the effects of topical application of a spray formula of chlorhexidine gluconate and benzydamine hydrochloride (Kloroben^? oral spray, 30 mL) on postoperative sore throat due to LMA use. The secondary aims were to evaluate earache, swallowing difficulty, nausea and vomiting and the hemodynamic responses due to LMA insertion and the incidence of coughing, tooth clenching, desaturation and laryngeal spasms during LMA removal.

METHODS: After obtaining Institutional Ethics Committee approval and written informed consent (Ref no 29/15), a total of 100 adult patients were included. In Group C, four puffs of a spray formula of chlorhexidine gluconate and benzydamine hydrochloride were applied to the nasopharyngeal area 15 min before surgery. In Group S, 0.9% saline was applied, using the same protocol.

RESULTS: When both groups were compared, more patients in Group S had cough, sore throat and swallowing difficulties one hour after surgery (P<0.05), but there was no statistically significant difference at 6, 12, and 24 h between the two groups (P>0.05). The incidence of nausea, vomiting, and earaches was similar in both groups at all measurement times (P>0.05).

CONCLUSIONS: Preemptive topical benzydamine hydrochloride and chlorhexidine gluconate in a spray formula may decrease the incidence of sore throat, cough and swallowing difficulties associated with LMA use.