金喉健喷雾剂对免充气喉罩置入术后并发症的影响

Effect of Jinhoujian spray on postoperative complications after non-inflatable laryngeal mask implantation

目的探讨金喉健喷雾剂对免充气喉罩(streamlined liner of pharyngeal airway,SLIPA)置入术后咽喉痛的影响。方法选择2024年1月1日至2024年5月31日在河南科技大学附属许昌市中心医院择期在喉罩全身麻醉下行下肢骨折手术的患者,采用随机数字表法分为利多卡因气雾剂组(利多卡因组)与金喉健喷雾剂组(金喉健组),每组50例。将金喉健喷雾剂或利多卡因气雾剂分别涂抹于喉罩环形封闭罩正反面,在全身麻醉静脉诱导后,由同一位麻醉医师以盲探标准法置入喉罩。比较2组患者喉罩置入前(T0)、喉罩置入即刻(T1)、喉罩置入后3 min(T2)、喉罩置入后5 min(T3)、喉罩置入后10 min(T4)、喉罩拔除即刻(T5)、喉罩拔除后3 min(T6)和喉罩拔除后5 min(T7)的平均动脉压(mean arterial pressure,MAP)和心率(heart rate,HR)。比较2组患者喉罩拔除后应激反应(呛咳、气道痉挛、躁动和恶心呕吐)及不良反应(舌麻、环杓关节脱位、吞咽困难、保护性反射受限和咽腭弓损伤)的发生率。比较2组患者喉罩拔除后0.5 h数字评估量表(numeric rating scale,NRS)评分,以及24 h NRS评分、声音嘶哑及拔管反应等情况。结果2组患者基线资料和各时间点(T0~7)的MAP和HR差异无统计学意义。金喉健组喉罩拔除后恶心呕吐发生率低于利多卡因组(P=0.021)。2组患者拔除喉罩后0.5 h NRS评分差异无统计学意义;拔除喉罩后24 h,金喉健组NRS(P=0.027)、Prince-Henry评分(P=0.002)和口腔黏膜炎评分(P=0.026)均低于利多卡因组。结论金喉健喷雾剂用于喉罩全身麻醉下肢骨折手术患者,能有效降低术后恶心呕吐发生率,减轻喉罩拔除后24 h咽喉痛及口腔黏膜炎,提高患者术后的舒适度。

Objective To explore the effect of Jinhoujian spray on postoperative sore throat(POST)after implantation of streamlined liner of pharyngeal airway(SLIPA)in general anesthesia.Methods A total of 100 patients undergoing lower limb fracture surgery with laryngeal mask general anesthesia in Xuchang Central Hospital,Henan University of Science and Technology from January 1,2024,to May 31,2024 were randomly divided into Jinhoujian spray group(Jinhoujian group)and lidocaine aerosol group(lidocaine group),with 50 cases in each group.Jinhoujian spray and lidocaine aerosol were applied to both sides of the laryngeal mask sealing cover,and after intravenous induction of general anesthesia,the same anesthesiologist inserted the laryngeal mask using a blind probing standard method.Mean arterial pressure(MAP)and heart rate(HR)were compared between the two groups at different time points:before laryngeal mask insertion(T0),immediately after insertion(T1),3 minutes after insertion(T2),5 minutes after insertion(T3),10 minutes after insertion(T4),immediately after mask removal(T5),3 minutes after removal(T6),and 5 minutes after removal(T7).The incidences of stress responses(coughing,airway spasm,agitation,nausea and vomiting)and adverse reactions(tongue numbness,arytenoid joint dislocation,dysphagia,restricted protective reflexes,and pharyngeal arch injury)after laryngeal mask removal were compared between the two groups.The numeric rating scale(NRS)at 0.5 h,and NRS,hoarseness,and extubation reaction at 24 h after mask removal were compared between the two groups.Results There were no statistically significant differences in baseline data and MAP and HR values at each time point(T0-7)between the two groups.Compared with the lidocaine group,the patients in Jinhoujian group had a lower incidence of nausea and vomiting after laryngeal mask removal(P=0.021).There was no statistically significant difference in the numeric rating scale(NRS)score 0.5 h after laryngeal mask removal between the two groups.Compared to the lidocaine group,the patients in Jinhoujian group had significantly lower scores of NRS(P=0.027),Prince-Henry(P=0.002),and oral mucositis(P=0.026)24 h after laryngeal mask removal.Conclusions Jinhoujian spray can effectively reduce incidence of postoperative nausea and vomiting,alleviate POST and oral mucositis 24 h after laryngeal mask removal,improving patient comfort after lower limb fracture surgery.