地塞米松涂抹气管导管对经鼻插管全身麻醉术后咽喉部并发症的影响

Effect of dexamethasone smeared endotracheal tube on postoperative throat complications after the nasal tracheal intubation general anesthesia

目的探讨地塞米松复合利多卡因胶浆涂抹气管导管,对经鼻气管插管全身麻醉术后咽喉部并发症的影响。方法选择2011年1月至2012年1月我院200例经鼻气管插管全身麻醉的口腔科择期手术患者,按随机数字表分为2组,对照组:0.9%氯化钠注射剂复合2%利多卡因胶浆涂抹气管导管表面;地塞米松组:0.5%地塞米松复合2%利多卡因胶浆涂抹气管导管表面。每组100例。记录2组患者的年龄、性别、身高、体质量、导管型号、插管次数以及术后1、6、24 h声音嘶哑、咽喉疼痛及咳嗽的发生情况,并对记录指标进行统计学分析。结果 2组患者术后均未发生严重声音嘶哑。地塞米松组患者术后1、6、24 h声音嘶哑发生率(16.32%、13.27%、11.22%)均低于对照组(35.35%、30.30%、26.26%)(P均<0.05);咽喉疼痛发生率(19.39%、14.29%、9.18%)均低于对照组(47.47%、34.34%、25.25%)(P均<0.05);咳嗽的发生率(40.16%、36.73%、29.59%)均低于对照组(56.57%、51.52%、41.41%)(P均<0.05);而且地塞米松组在各时间点并发症的严重程度明显低于对照组(P<0.05)。结论地塞米松复合利多卡因胶浆涂抹气管导管,可减少经鼻气管插管全身麻醉术后咽喉部并发症的发生。

AIM To explore the effect of dexamethasone compound lidocaine mucilage smeared endotracheal tube on postoperative complications of throat after the nasal tracheal intubation general anesthesia. METHODS A total of 200 adult patients undergoing selective oral surgery who required the nasal tracheal intubation general anesthesia were random- ly divided into 2 groups ： group A（ control group） 0.9 % sodium chloride injection compound 2% lidocaine mucilage smeared endotracheal tube, group B （dexamethasone group） 0.5 % dexamethasone compound 2% lidocaine mucilage smeared endotraeheal tube, 100 patients in each group. Records of each patient＇ s age, sex, height, weight, and the types of endotracheal tube, number of intubation and hoarseness, sore throat and cough occurrence at postoperative 1, 6 and 24 h were made. RESULTS The incidence of hoarseness at 1, 6 and 24 h after operation in dexamethasone group （16.32%, 13.27%, 11.22% ） were lower than the control group（35.35% ,30.30% ,26.26% ; P 〈 0.05） and no se- vere hoarseness was detected in either group; the incidence of sore throat at 1, 6 and 24 h after operation in dexametha- sone group （19.39%, 14.29% ,9.18% ）were lower than the control group（47.47% ,34.34% ,25.25% ; P 〈 0.05） ; the incidence of cough at 1,6 and 24 h after operation in dexamethasone group（40.16%, 36.73 %, 29.59 % ）were lower than the control group（56.57% ,51.52% ,41.41% ; P 〈 0.05）. CONCLUSION Dexamethasone compound lidocaine mucilage smeared endotracheal tube can decrease the incidence and severity of postoperative hoarseness, sore throat and cough when the nasal tracheal intubation general anesthesia is done.