一项比较腹腔镜手术中男患使用7.5mm和6.5mm气管导管及女患使用7.0 mm和6.0 mm气管导管的随机对照试验

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一项比较腹腔镜手术中男患使用7.5mm和6.5mm气管导管及女患使用7.0 mm和6.0 mm气管导管的随机对照试验

贵州医科大学 高鸿教授课题组

翻译：吴学艳  编辑：佟睿  审校：曹莹

摘要

气管插管后喉咙疼痛影响术后恢复；随机将172名ASA分级1-2级的受试者分配到腹腔镜手术中，采用较大的气管导管插管(n=88)或较小的气管导管插管(n=84)，其中男性气管导管内径为7.5mm与6.5mm，女性气管导管内径为7.0mm与6.0mm；主要观察指标为术后1h喉咙疼痛发生率，较大气管导管内径无、轻、中、重度喉咙疼痛发生率分别为60、10、17和1例，较小气管导管内径者分别为79、5、0和0例，P<0.001。术后24小时较大气管导管内径者与较小气管导管内径者喉咙疼痛发生率分别为64、16、8和0例与74、6、3和1例，P=0.037。术中通气变量不受管径影响，包括吸气峰压、平台压和呼气末二氧化碳分压；总之，较小管径气管插管有利于腹腔镜手术患者的康复。

Figure 1 Study flflow chart.

原始文献来源：

Cho HY, Yang SM, Jung CW, et al. A randomised controlled trial of 7.5-mm and 7.0-mm tracheal tubes vs. 6.5-mm and 6.0-mm tracheal tubes for men and women during laparoscopic surgery[J]. Anaesthesia. 2021 Aug 17. DOI: 10.1111/anae.15568.

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A randomised controlled trial of 7.5-mm and 7.0-mm tracheal tubes vs. 6.5-mm and 6.0-mm tracheal tubes for men and women during laparoscopic surgery

Abstract

Sore throat after tracheal intubation impairs postoperative recovery. We randomly allocated 172 ASA physical status 1–2 participants, scheduled for laparoscopic lower abdominal surgery, to tracheal intubation with larger tubes (n = 88) or smaller tubes (n = 84), with internal diameters 7.5-mm vs. 6.5-mm for men and 7.0-mm vs. 6.0-mm for women. Primary outcome was the rates of no, mild, moderate or severe sore throat 1 h after surgery, which were 60, 10, 17 and 1 with larger tracheal tubes and 79, 5, 0 and 0 with smaller tubes, p < 0.001. The equivalent rates 24 h after surgery were 64, 16, 8 and 0 vs. 74, 6, 3 and 1, p = 0.037. Intra-operative ventilatory variables were unaffected by tube diameter, including peak inspiratory pressure, plateau pressure and endtidal carbon dioxide partial pressure. In summary, smaller tracheal tubes benefitted patients having laparoscopic operations.

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