目的:评估围插管非药物干预在减少术后咽喉痛(POST)中的有效性,咳嗽(PEC),手术病人的声音嘶哑.
方法:采用meta分析和meta回归的系统评价。
方法:手术室全身麻醉下择期手术。
方法:评估非药物干预措施的影响,包括插管前(用唑烯磺酸钠漱口,甘草,或使用蜂蜜和柠檬锭剂的Strepsils片剂),插管期间(用生理盐水充胀TT袖带,用温热生理盐水软化ETT袖带),和插管后(冷蒸气疗法,用蜂蜜柠檬水漱口,并使用绿茶漱口),在POST发生时,PEC,和声音嘶哑。
结果:纳入19项试验,2,136名参与者。插管前干预显著降低拔管后即刻POST(n=861;OR:0.28,95%CI:0.20-0.38,P<0.001),拔管后24小时(n=1006;OR:0.21,95%CI:0.16-0.28,P<0.001)。插管期间干预对POST没有显着影响。插管前干预也降低了拔管后24h的POST相关疼痛评分(n=440;MD:-0.50,95%CI:-0.81至-0.18,P<0.001)。插管后干预可有效降低拔管后不同时间点的POST相关疼痛评分(P<0.05)。插管前干预可显著降低拔管后24h的PEC(OR:0.13,95%CI:0.02-0.70,P=0.02)和声音嘶哑(OR:0.36,95CI:0.15-0.86,P=0.02)。然而,插管期间的干预并不能减少拔管后24小时的声音嘶哑.
结论:插管前非药物干预被发现在降低POST的发生率和严重程度方面最有效。PEC,和声音嘶哑。
结论:实施插管前非药物干预措施有利于床旁护士和医护人员减少术后并发症,护士有助于提高患者舒适度和术后恢复效果。
■该方案于2024年1月2日在PROSPERO国际前瞻性系统评价登记册中注册(CRD42023492813)。
OBJECTIVE: To evaluate the effectiveness of peri-intubation non-pharmacological interventions in reducing postoperative sore throat (POST), cough (PEC), and
hoarseness in surgical patients.
METHODS: A systematic
review with meta-analysis and meta-regression.
METHODS: Elective surgery under general anesthesia in operating rooms.
METHODS: Evaluate the impact of non-pharmacological interventions, including pre-intubation (gargling with Sodium Azulene Sulfonate, licorice, or using Strepsils tablets of honey and lemon lozenge), during-intubation (inflating the TT cuff with normal saline and softening the ETT cuff with warm normal saline), and post-intubation (cold vapor therapy, gargling with honey lemon water, and using green tea gargle), on the occurrence of POST, PEC, and
hoarseness.
RESULTS: Nineteen trials with 2,136 participants were included. Pre-intubation intervention significantly reduced POST immediately after extubation (n = 861; OR: 0.28, 95 % CI: 0.20-0.38, P < 0.001), and 24 h post-extubation (n = 1006; OR: 0.21, 95 % CI: 0.16-0.28, P < 0.001). During-intubation intervention did not show significant effects on POST. Pre-intubation intervention also reduced POST-associated pain score at 24 h post-extubation (n = 440; MD: -0.50, 95 % CI: -0.81 to -0.18, P < 0.001). Post-intubation interventions were effective in reducing POST-associated pain scores at different time points post-extubation (P < 0.05). Pre-intubation intervention significantly reduced PEC (OR: 0.13, 95 % CI: 0.02-0.70, P = 0.02) and
hoarseness (OR: 0.36, 95 %CI: 0.15-0.86, P = 0.02) at 24 h post-extubation. However, during-intubation interventions did not reduce
hoarseness at 24 h post-extubation.
CONCLUSIONS: Pre-intubation non-pharmacological interventions were found to be the most effective in reducing the incidence and severity of POST, PEC, and hoarseness.
CONCLUSIONS: Implementing pre-intubation non-pharmacological interventions can be beneficial for bedside nurses and healthcare professionals in reducing postoperative complications and nurses can contribute to improving patient comfort and recovery outcomes following surgery.
UNASSIGNED: The protocol was registered in the PROSPERO international prospective register of systematic reviews on 2 January 2024 (CRD42023492813).