倍他米松凝胶对气管内插管术后咽喉痛和咳嗽及声音嘶哑的预防效果

摘要

目的 探讨倍他米松凝胶对气管内插管术后咽喉痛、咳嗽和声音嘶哑的预防效果.方法 选择2013年1月至2015年12月于河北省唐山市妇幼保健院择期行全身麻醉下非头颈部手术的患者150例,采用随机数字表法分为倍他米松凝胶组、利多卡因胶浆组和对照组,各50例.倍他米松凝胶组在气管导管前端涂抹0.05％倍他米松,利多卡因胶浆组在气管导管前端涂抹利多卡因胶浆,2组均涂抹至导管口以上10 cm,对照组不涂抹任何物质.比较3组患者术后1、6、12、24h咽喉痛、咳嗽和声音嘶哑的发生情况.结果 倍他米松凝胶组术后6、12、24h咽喉痛、咳嗽、声音嘶哑发生率均明显低于对照组和利多卡因胶浆组[术后6h:14.0％ (7/50)比100.0％(50/50)、88.0％ (44/50),4.0％ (2/50)比34.0％ (17/50)、24.0％ (12/50),4.0％(2/50)比54.0％ (27/50)、44.0％(22/50);术后12 h:22.0％(11/50)比100.0％ (50/50)、100.0％ (50/50),4.0％(2/50)比28.0％(14/50)、38.0％(19/50),4.0％(2/50)比50.0％(25/50)、46.0％ (23/50);术后24h:40.0％(20/50)比100.0％(50/50)、100.0％ (50/50),6.0％ (3/50)比28.0％(14/50)、40.0％(20/50),4.0％(2/50)比50.0％(25/50)、42.0％ (21/50)],差异均有统计学意义(均P＜0.05).结论 气管内插管时使用倍他米松凝胶广泛涂抹气管导管能明显减少术后咽喉痛、咳嗽和声音嘶哑的发生.%Objective To explore the effect of bertamethasone gel on postoperative sore throat,cough and hoarseness after endotracheal intubation.Methods Totally 150 patients admitted for non-head and neck operation under general anesthesia from January 2013 to December 2015 in Tangshan Maternal and Child Health Care Hospital were randomized into betamethasone group,lidocaine group and control group,with 50 cases in each group.In betamethasone group,0.05％ betamethasone gel was spreaded on the front of tracheal tube before endotracheal intubation;in lidocaine group,lidocaine jelly was spreaded on the front of tracheal tube;betamethasone gel and lidocaine jelly were spreaded to 10 cm away from the tube opening;no reagent was applied in control group.Incidences of sore throat,cough and hoarseness were analyzed at 1,6,12,and 24 h after operation.Results At 6,12,24 h after operation,incidences of sore throat,cough and hoarseness in betamethasone group were significantly lower than those in control group and lidocaine group [6 h after operation:14.0％ (7/50) vs 100.0％ (50/50),88.0％(44/50);4.0％ (2/50) vs 34.0％ (17/50),24.0％ (12/50);4.0％ (2/50) vs 54.0％ (27/50),44.0％ (22/50);12 h after operation:22.0％ (11/50) vs 100.0％ (50/50),100.0％ (50/50);4.0％ (2/50) vs 28.0％ (14/50),38.0％ (19/50);4.0％ (2/50) vs 50.0％ (25/50),46.0％ (23/50);24 h after operation:40.0％ (20/50) vs 100.0％ (50/50),100.0％ (50/50);6.0％ (3/50) vs 28.0％ (14/50),40.0％ (20/50);4.0％ (2/50) vs 50.0％ (25/50),42.0％ (21/50)] (all P ＜ 0.05).Conclusion The application of betamethasone gel during endotracheal intubation can significantly reduce the occurrences of postoperative sore throat,cough and hoarseness.