全身麻醉病患接受聲帶噴劑對術後喉嚨痛的影響

Influence of spraying the vocal cords on postoperative sore throat in adults undergoing general anesthesia- A retrospective study in Taiwanese population

背景及目的：經由聲帶使用局部麻醉劑是臨床常用的麻醉技術，而本研究目的則是以病例回顧方式探討10%lidocaine嘖劑對手術後喉嚨痛的影響。研究設計：採用回溯分析，麻醉紀錄與術後訪視紀錄共294位不同手術方式之全身麻醉，經口氣管內管插入成人患者。分成兩組，控制組（C組）有206位患者，接受標準的全身麻醉氣管內插管﹔噴劑組（S組）有88位患者同樣為氣管插管，然在氣管內插管前，使用10%lidocaine噴劑（lmg／kg）。主要評估包括手術24小時後喉嚨痛的影響及嚴重度。實驗結果：我們比較這兩組喉嚨痛方式，發現手術當天喉嚨痛發生率並無統計差異，c組29.5草，s組33.5寬（p>0.05）﹔但中重度喉嚨痛發生比例c組為10.訝，顯著地比S組18.2%低（p<0.05）。手術後隔天喉嚨痛發生率及嚴重度均比前一天減少。研究結論：聲帶使用10%lidocaine噴劑可能手術後喉嚨痛會較嚴重，應該避免常規使用於預防手術後喉嚨痛。

Background: Topical application of local anaesthetic solution to the vocal cords is a technique commonly employed in anaesthetic practice. The purpose of present study was to explore the influence of 10% lidocaine spray on postoperative sore throat (POST) retrospectively. Materials and methods: The anesthetic and postoperative visit records of 294 orotracheally intubated adult patients undergoing general anesthesia for various elective surgery were analyzed retrospectively. The enrolled patients were divided into two groups: (1) control group (group C), 206 patients received standard general anesthesia induction; (2) spraying group (group S), 88 patients received the same induction regimen and spraying vocal cords with 10% lidocaine (lmg/kg) before tracheal intubation. Main outcomes evaluations included the incidence and severity of postoperative sore throat on the day and 1st day after surgery. Results: The overall incidence of sore throat was comparable between two groups, 29.5 % in group C and 33.5 % in group S (p>0.05) on the day of surgery. The ratio of moderate and severe sore throat was significant lower in group C (10.2%) than in group S( 18.2%) on the day of surgery and the day after surgery (6.8% vs 11.3%) (both p<0.05). Both incidence and severity of POST diminished on the 1st day after surgery. Conclusion: Spraying the vocal cords with 10% lidocaine spray may contribute to higher severity of postoperative sore throat, and should be avoided routinely to prevent POST.