术前应用漱口水对宫腔镜手术患者术后咽喉痛的影响

目的:观察术前应用洗必泰漱口水对宫腔镜手术患者喉罩全麻术后咽喉痛的影响。方法:选取2020年11月至2021年3月110例喉罩全麻下行宫腔镜手术患者,年龄20~60岁,BMI 20~30 kg/m²,ASA I或II级,采用随机数字表将110例患者分成漱口水组(S组)和对照组(C组),每组各55例。在全麻诱导前5~10 min分别让患者漱口1~2min或者做两次空漱口后吞咽的动作。依次使用舒芬太尼、丙泊酚、琥珀胆碱进行麻醉诱导并置入SLIPA喉罩,术中持续泵注丙泊酚维持麻醉。观察术后2h、6h和24h的咽喉痛发生情况。结果:漱口水组患者咽喉痛评分在术后24h时明显低于对照组患者(P<0.05)。术后2h和6h喉罩表面不带血迹的咽喉痛评分低于喉罩表面带血迹的患者(P<0.05)。术后24h内中/重度咽喉痛(NRS＞3)的发生率,S组(9.43%)明显低于C组(35.19%)(P<0.01)。喉罩带血迹的发生率两组相似,在喉罩表面带血的患者中,术后24h内中/重度咽喉痛发生率S组(11.76%)显著低于C组(56.52%)(P<0.01)。漱口水组发生中/重度咽喉痛的几率明显降低(OR=0.258,P =0.02)。结论:术前应用漱口水可以有效预防喉罩全麻下宫腔镜手术患者术后中/重度咽喉痛的发生,尤其是降低咽喉部粘膜损伤患者术后中/重度咽喉痛的发生率。

Effect of preoperative gargle on postoperative sore throat in patients with laryngeal mask general anesthesia

Objective To explore the effect of preoperative chlorhexidine mouthwash on sore throat after hysteroscopy under general anesthesia of laryngeal mask airway. Methods From November 2020 to March 2021, 110 cases of hysteroscopic operation under general anesthesia of laryngeal mask from Obstetrics and Gynaecology Hospital, Fudan University were performed. Patients were randomly divided into mouthwash group and control group, with 55 patients in each group. 5-10 min before induction of anesthesia, the patients were asked to gargle for 1-2 min or to swallow after two empty gargle without mouthwash. Anesthesia induction was performed with sufentanil, propofol and succinylcholine, and SLIPA laryngeal mask was placed. Anesthesia was maintained by continuous infusion of propofol. The incidence and severity of sore throat at 2 h, 6 h and 24 h after operation were observed. Results The sore throat score in mouthwash group was significantly lower than that in control group at 24 h after surgery (P<0.05). Sore throat score without blood on the laryngeal mask was lower in the two groups than in the patients with blood on the laryngeal mask at 2 h and 6 h (P<0.05). The incidence of moderate/severe sore throat (NRS>3) within 24 h after surgery was significantly lower in the mouthwash group (9.43%) than in the control group (35.19%, P<0.01). There was no difference in the incidence of blood stains on the laryngeal mask between the two groups. Among patients with blood on the laryngeal mask, the incidence of moderate/severe sore throat was significantly lower in the mouthwash group (11.76%) than that in the control group (56.52%) in 24 h after surgery (P<0.01). The incidence of moderate/severe sore throat was significantly reduced in the mouthwash group(OR=0.258, P=0.02). Conclusion Preoperative mouthwash application can effectively prevent the occurrence of postoperative moderate/severe sore throat in patients undergoing hysteroscopy under general anesthesia of laryngeal mask, especially reduce the incidence of postoperative moderate/severe sore throat in patients with injury of larynx.