在全身麻醉下进行鼻腔内镜手术后多式预防出现咳:双盲随机试验
Jing Xu1, Pei Sun1, Jia-Hui Ma1
1Department of Anesthesiology, Peking University First Hospital, Beijing, China.
Frontiers in medicine
|February 8, 2024
概括
多模式干预显著减少了经过鼻腔手术的患者的出现咳. 这种结合罗皮瓦卡因,德克斯梅德托米丁和雷米芬坦尼尔的方法,与标准护理相比,被证明是安全有效的.
科学领域:
- 麻醉学 麻醉学
- 手术患者护理手术患者护理
- 呼吸系统医学 呼吸系统医学
背景情况:
- 麻醉后出现的咳是鼻腔内镜手术中经常出现的并发症.
- 现有的单一疗法用于预防新出现的咳,由于患者特定的因素,其疗效有所变化.
- 与出现咳相关的不良事件需要有效的预防策略.
研究的目的:
- 评估多模式干预措施的有效性和安全性,以预防鼻腔内镜手术的成年患者出现咳.
- 为了比较多式干预组,双式干预组和对照组之间出现咳的发生率.
主要方法:
- 一个双盲随机试验,涉及150名接受鼻腔内镜手术的成年患者.
- 确定了三个组:对照组 (常规麻醉),双重干预 (盐水喷雾,德克斯梅托米丁,雷米芬坦尼尔) 和多式干预 (罗皮瓦卡因喷雾,德克斯梅托米丁,雷米芬坦尼尔).
- 突发性咳被定义为从手术结束到输出管后5分钟的一个或多个咳.
主要成果:
- 与对照组 (98%) 和双重干预组 (90%) 相比,多式干预组 (70%) 的出现咳的发生率明显较低 (分别为p < 0.001和p = 0.012).
- 双重干预和对照组之间没有观察到出现咳发生率的显著差异 (p = 0.20).
- 多模式组报告的喉疼痛严重程度明显低于对照组 (p = 0.016),在不同组的其他不良事件中没有显著差异.
结论:
- 多种模式的干预,包括局部罗皮瓦卡因,德克斯梅德托米丁和雷米芬坦尼尔,有效地减少了接受内鼻外科手术的患者的出现咳.
- 这种策略是安全的,耐受性很好,为管理麻醉后的呼吸道反射提供了改进的方法.
- 这些发现支持使用多式麻醉技术,以提高鼻内镜手术后患者的康复和舒适度.
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