地塞米松联合盐酸奥布卡因凝胶用于预防鼻内镜术后咽喉痛

doi:10.19723/j.issn.1671-167X.2022.02.015

Abstract

Abstract:

Objective: To explore the effectiveness and feasibility of dexamethasone combined with oxybuprocaine hydrochloride gel on the prevention of postoperative sore throat after nasal endoscopy. Methods: In the study, 60 patients with American Society of Anesthesiologist (ASA) physical statuses Ⅰ to Ⅱ, aged 18 to 72 years, scheduled for elective nasal endoscope surgery under general anesthesia requiring endotracheal intubation were randomly divided into dexamethasone combined with oxybuprocaine hydrochloride gel group (G group, n=30) and control group (C group, n=30). The patients in the G group received dexamethasone 0.1 mg/kg before induction and the oxybuprocaine gel was applied to the endotracheal catheter cuff and the front end within 15 cm. The patients in the C group received the same dose of saline and the saline was applied to the endotracheal catheter cuff and the front end within 15 cm. Then, all the patients in the two groups received the same induction and anesthesia maintainance. The operation time, anesthesia time, emergence time, extubation time and departure time were recorded. The intraoperative infusion volume, blood loss volume, propofol, remifentanil, rocuronium dosage were also recorded. The adverse reactions such as intraoperative hypotension, bradycardia and postoperative agitation were recorded. The postoperative sore throat score was recorded at the end of operation and 4 h, 8 h, 12 h, and 24 h after operation. Results: Compared with the C group, the emergence time [(8.4±3.9) min vs. (10.8±4.7) min], extubation time [(8.8±3.7) min vs. (11.9±4.8) min], and departure time [(20.0±5.3) min vs. (23.0±5.8) min] were significantly shorter, and the propofol dosage [(11.8±1.8) mg/kg vs. (15.9±4.6) mg/kg], remifentanil dosage [(10.9±4.7) μg/kg vs. (14.1±3.6) μg/kg] were significantly less in the G group, and there was no difference of rocuronium dosage in the two groups. Compared with the C group the incidence of intraoperative hypotension [10%(3/30) vs. 30%(9/30)], bradycardia [16.7%(5/30) vs. 20%(6/30)] and postoperative agitation [6.7%(2/30) vs. 23.3%(7/30)] were significantly lower in the C group. The postoperative sore throat score at the end of operation, 4 h, 8 h, 12 h and 24 h after operation in the G group were significantly lower than in the C group respectively [0 (0, 1) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (0.75, 1), 0 (0, 0) vs. 1 (0, 1)]. Conclusion: Dexamethasone combined with oxybuprocaine hydrochloride gel was effective and feasible on the prevention of postoperative sore throat after nasal endoscopy.

Key words: Dexamethasone, Oxybuprocaine hydrochloride gel, Postoperative sore throat, Nasal endoscopy

CLC Number:

R765.9

SHI Cheng-mei,WANG Xue-dong,LIU You-kun,DENG Ying,GUO Xiang-yang. Effect of dexamethasone combined with oxybuprocaine hydrochloride gel on prevention of postoperative sore throat after nasal endoscopy[J].Journal of Peking University (Health Sciences), 2022, 54(2): 289-293.

Figures/Tables 5

Table 1

Demographic characteristics of the two groups"

Items	Group G (n=30)	Group C (n=30)
Gender, female/male	13/17	12/18
Age/years, $x -$ ±s	39.5±15.5	43.5±12.9
Height/cm, $x -$ ±s	168.6±7.2	166.1±5.7
Weight/kg, $x -$ ±s	68.4±14.1	66.5±10.7
Mallampati grade, M(P₂₅, P₇₅)	2 (1, 2.25)	2 (1, 2)

Table 1

Table 2

Table 3

Table 4

Table 5

References 24

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Items	Group G (n=30)	Group C (n=30)
Operating time/min	85.2±46.6	76.3±50.9
Transfusion volume/mL	800.0±249.1	786.7±315.9
Blood loss/mL	18.5±9.2	13.7±6.5

Items	Group G (n=30)	Group C (n=30)
Anesthesia time/min	103.8±50.2	94.3±51.7
Emergence time/min	8.4±3.9^*	10.8±4.7
Extubation time/min	8.8±3.7^*	11.9±4.8
Departure time/min	20.0±5.3^*	23.0±5.8
Propofol dosage/mg	805.8±259.1^*	1 057.7±500.1
Remifentanil dosage/μg	748.3±340.3^*	938.7±392.5
Muscular relaxant dosage/mg	48.3±4.6	49.5±12.6

Items	Group G (n=30)	Group C (n=30)
Hypotension, n(%)	3 (10.0)^*	9 (30.0)
Bradycardia, n(%)	5 (16.7)^*	6 (20.0)
Postoperative agitation, n(%)	2 (6.7)^*	7 (23.3)

Effect of dexamethasone combined with oxybuprocaine hydrochloride gel on prevention of postoperative sore throat after nasal endoscopy

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Items	Sore throat	Group G (n=30)	Group C (n=30)	Sore throat score M(P₂₅, P₇₅)			95%CI
Items	Sore throat	Group G (n=30)	Group C (n=30)	Group G (n=30)	Group C (n=30)	Median difference	Low	High
End of operation	0	21	6	0 (0, 1)^*	1 (1, 2)	1	0.074	0.176
	1	9	16
	2	0	7
	3	0	1
4 h after operation	0	25	6	0 (0, 0)^*	1 (1, 2)	1	0.114	0.256
	1	5	17
	2	0	6
	3	0	1
8 h after operation	0	27	7	0 (0, 0)^*	1 (1, 2)	1	0.312	0.094
	1	3	16
	2	0	7
	3	0	0
12 h after operation	0	27	8	0 (0, 0)^*	1 (0.75, 1)	1	0.042	0.113
	1	3	19
	2	0	3
	3	0	0
24 h after operation	0	27	13	0 (0, 0)^*	1 (0, 1)	1	0.156	0.271
	1	3	15
	2	0	2
	3	0	0

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