以不同的姿勢進行Lightwand插管造成病人手術後喉嚨痛之比較

Postoperative Sore Throat: Comparison of the Different Positions Endotracheal Intubation with Lightwand

背景：病人在仰臥和側臥的姿勢下，以Lightwand進行插管而造成病人喉嚨痛（sorethroat）與聲音沙啞（hoarseness）的實料是有限的。因此，本研究的目的是探討病人在不同的姿勢下，以Lightwand輔助插管而造成病人喉嚨痛與聲音沙啞的關聯性。方濤：120位的病人被隨械地分成3組。經靜脈注射的誘導藥物是fentanyl（2µg／kg）,atracuriurn（0.5mg／kg）,thiopental（5mg／kg）。氣管內管（男性：8.0凹，女性：7.5mm內徑）被用來建立通暢的呼吸道。TS組的病人是以仰臥的姿勢經由Lightwand輔助插管。TR組的病人是以右側臥的姿勢經由Lightwand輔助插管。TL組的病人是以左側臥的姿勢經由Lightwand輔助插管。結果：4位TS組，3位TL組，8位四組的病人，第一次插管失敗後，被排除在本研究之外。喉嚨痛的評分和聲音沙啞的分級在各組間是相似的。沒有任何一個病人報評分嚴重的喉嚨痛和被分級是嚴重的聲音沙啞。在手術後第二天，喉嚨痛的分數明顯地下降，聲音沙啞的分級是無或輕微的沙啞。結論：在仰臥和側臥的姿勢下，以Lightwand進行插管是可行的。達意味若以不同的姿勢，經由Lightwand進行插智商造成喉嚨痛與聲音沙啞是相似的。

Background: There is limited data of sore throat and hoarseness on intubation with Lightwand in the supine position or lateral decubitus position. Therefore, the aim of this study is to investigate postoperative sore throat and hoarseness by Lightwand-assisted intubation in different positions. Materials and methods: One hundred and twenty patients who underwent surgical intervention were randomly enrolled into 3 groups. Induction agents were fentanyl (2 mg /kg), atracurium (0.5 mg/kg), and thiopental (5 mg/kg) intravenously. A proper ETT (inner diameter ETT; male: 8.0, female: 7.5) was set to establish airway patency. Group TS patients received Lightwand - assisted intubation and operation in supine position. Group TR patients were in a right decubitus position during Lightwand - assisted intubation. Group TL patients were in a left decubitus position during Lightwand - assisted intubation. Results: Four patients in group TS, 3 patients in group TL, and 3 patients in group TR who needed re-intubation after an unsuccessful first attempt were excluded. The score of sore throat and grades of hoarseness were comparable among groups. No one was graded to severe hoarseness or/and scored to severe sore throat. Score of sore throat was obviously decreased and the rank of hoarseness was graded to none or mild hoarseness in majority of patients in the next morning. Conclusion: Lightwand-assisted ETT is feasible for patients in lateral decubitus or supine position. Lightwand-assisted ETT gives rise to comparable sore throat and hoarseness levels with patients in different positions.