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| 复方甘菊利多卡因凝胶对喉罩通气患儿术后口咽部并发症的影响 |
| Effect of compound chamomile-lidocaine gel on postoperative oropharynx complications during laryngeal mask airway ventilation in children |
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| DOI：10.12089/jca.2022.08.005 |
| 中文关键词: 喉罩 儿童 复方甘菊利多卡因凝胶 术后咽喉痛 声音嘶哑 口咽黏膜炎 |
| 英文关键词: Laryngeal mask Children Compound chamomile-lidocaine gel Postoperative sore throat Hoarseness Oropharyngeal mucositis |
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| 中文摘要: |
目的 观察和评估复方甘菊利多卡因凝胶对全麻喉罩通气患儿术后口咽部并发症的影响。
方法 选择2021年7—9月全麻下使用喉罩通气的患儿117例，男81例，女36例，年龄6～12岁，BMI 10～30 kg/m2，ASA Ⅰ或Ⅱ级，Mallampati Ⅰ—Ⅲ级。将患儿随机分为三组：石蜡油组（A组，n=39）、复方利多卡因乳膏组（B组，n=40）和复方甘菊利多卡因凝胶组（C组，n=38）。A组、B组和C组分别将石蜡油、复方利多卡因乳膏和复方甘菊利多卡因凝胶均匀涂抹于喉罩罩头正反面。记录喉罩拔除后1、6、24、48 h咽喉痛评分和声音嘶哑评分。记录喉罩拔除即刻、喉罩拔除后1、6、24、48 h口腔黏膜炎评分。记录喉罩拔除即刻呛咳、喉痉挛、躁动、恶心呕吐以及苏醒期舌麻、保护性咽反射受限等不良反应发生情况。
结果 与A组比较，喉罩拔除后1、6 h，B组和C组术后咽喉痛等级发生率明显降低（P＜0.05），喉罩拔除后1 h，B组和C组声音嘶哑等级发生率明显降低（P＜0.05），喉罩拔除即刻、喉罩拔除后1、6 h，C组口咽黏膜炎等级发生率明显降低（P＜0.05），喉罩拔除即刻B组和C组呛咳发生率明显降低（P＜0.05）。三组苏醒期舌麻、保护性咽反射受限等不良反应发生率差异无统计学意义。
结论 复方甘菊利多卡因凝胶可降低术后咽喉痛、声音嘶哑和口咽黏膜炎等级发生率，减少喉罩拔除时的不良反应，且苏醒期舌麻、保护性咽反射受限等不良反应发生率无明显升高。 |
| 英文摘要: |
Objective To observe and evaluate the effect of compound chamomile-lidocaine gel on postoperative oropharynx complications in children undergoing general anesthesia surgery with laryngeal mask ventilation.
Methods A total of 117 children with laryngeal mask ventilation under general anesthesia from July to September 2021 were selected, 81 males and 36 females, aged 6-12 years, BMI 10-30 kg/m2, ASA physical status Ⅰ or Ⅱ, Mallampati grade Ⅰ-Ⅲ. They were randomly divided into three groups: paraffin oil group (group A, n = 39), compound lidocaine cream group (group B, n = 40) and compound chamomile-lidocaine gel group (group C, n = 38). Groups A, B and C applied paraffin oil, compound lidocaine cream and compound chamomile-lidocaine gel to the front and back of the laryngeal mask head evenly respectively. The sore throat and hoarseness scores were recorded 1, 6, 24, and 48 hours after laryngeal mask extraction. The oral mucositis scores were recorded immediately after laryngeal mask extraction and 1, 6, 24, and 48 hours after laryngeal mask extraction. The occurrence of stress reactions such as coughing, laryngospasm, restlessness, nausea and vomiting immediately after laryngeal mask removal were recorded. The occurrence of adverse reactions such as tongue numbness and limitation of protective gag reflex during recovery were recorded.
Results Compared with group A, the incidence of postoperative pharyngeal pain grade in groups B and C were significantly lower 1 and 6 hours after laryngeal mask removal (P < 0.05), the incidence of hoarseness grade in groups B and C were significantly lower 1 hour after laryngeal mask removal (P < 0.05), the incidence of oropharyngeal mucositis grade in group C was significantly lower immediately after laryngeal mask removal, 1 and 6 hours after laryngeal mask removal (P < 0.05), and the incidence of choking in groups B and C were significantly lower immediately after laryngeal mask removal (P < 0.05). There was no significant difference in the incidence of adverse reactions such as tongue numbness and protective pharyngeal reflex limitation among the three groups during recovery.
Conclusion Compound chamomile-lidocaine gel can reduce the incidence of grade of postoperative sore throat, hoarseness and oropharyngeal mucositis, relieve the adverse reactions when laryngeal mask is removed, and there is no significant increase in the incidence of adverse reactions such as tongue numbness and protective pharyngeal reflex limitation during awakening. |
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