成人患者全麻术后咽喉痛预防及管理的最佳证据总结

Summary of the best evidence for prevention and management of sore throat after general anesthesia in adult patients

目的系统检索并评价国内外关于成人患者全麻术后咽喉痛(POST)管理的相关文献,全面汇总并形成最佳实践证据,为临床工作者实施成人患者全麻POST管理提供循证依据。方法计算机检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、美国指南网、国际指南图书馆、加拿大安大略注册护士协会、Cochrane Library、PubMed、Embase、CINAHL、中国知网、万方数据库、中国生物医学文献数据库、澳大利亚和新西兰麻醉师学会、美国麻醉医师协会等国内外数据库和专业协会网站中关于成人患者全麻POST管理的相关证据,包括最佳实践、证据总结、指南、系统评价、专家共识及原始研究。检索时限为建库至2021年4月30日。由2名经过系统学习循证护理的研究人员独立进行纳入文献的质量评价,并对符合质量标准的文献进行证据提取和汇总。结果共纳入20篇文献,其中临床决策2篇、证据总结1篇、指南1篇、专家共识4篇、系统评价7篇、原始研究5篇,从POST识别和评估、人工气道管理、药物干预、非药物干预、多学科管理5个方面汇总24条最佳证据。结论临床工作者应重视和加强对成人患者全麻POST的管理,在选择应用相关证据时应充分考虑实际临床情景、证据实施的促进因素及阻碍因素、患者的意愿,确定最佳的实施方案,缓解患者全麻POST,提升护理质量。

Objective To systematically retrieve and evaluate the relevant literature on the management of postoperative sore throat(POST)in adult patients under general anesthesia at home and abroad,comprehensively summarize and form the best practice evidence,so as to provide evidence-based basis for clinical workers to implement POST management in adult patients after general anesthesia.Methods All evidence on postoperative sore throat in adults undergoing general anesthesia was searched from domestic and foreign databases and professional association websites including BMJ Best Practice,Up To Date,Joanna Briggs Institute(JBI)Evidence-based Health Care Center database,National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO),Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,Wanfang Database,China Biology Medicine disc,Australian and New Zealand College of Anaesthetists and American Society of Anesthesiologists.The searched evidence included best practice,evidence summaries,guidelines,systematic review,expert consensuses and original study.The search time limit was from the establishment of the database to April 30,2021.Two researchers who had systematically learned evidence-based nursing independently evaluated the quality of the included literature and extracted and summarized the evidence of the literature that met the quality criteria.Results Totally 20 pieces of literature were included,including 2 clinical decisions,1 evidence summary,1 guideline,4 expert consensuses,7 systematic reviews,5 randomized controlled trails.Finally,totally 24 pieces of best evidence were summarized from 4 aspects on identification and assessment of POST,artificial airway management,pharmacological interventions,non-pharmacological interventions and multidisciplinary management.Conclusions Clinicians should pay attention to and strengthen the management of POST in adult patients with general anesthesia.When selecting the application of relevant evidence,they should fully consider the actual clinical situation,the promoting factors and hindering factors of evidence implementation and the willingness of patients,so as to determine the best implementation plan,alleviate the POST of patients with general anesthesia and improve the quality of nursing.