目的:声门上气道装置(SAD)是短期麻醉应用中气管插管(ETI)的良好替代品,因为它们具有易于应用的优点,更低的成本,使自发通风。全静脉麻醉(TIVA)和允许快速恢复的地氟醚麻醉是要选择的麻醉方法。地氟醚吸入麻醉可能对气道粘膜和声带功能产生不良影响。本研究的目的是比较选择的麻醉方法对接受短期SAD麻醉的妇科患者的声音的影响。
方法:将计划在妇产科诊所进行短期手术的74例患者随机分为两组进行地氟醚麻醉(D组)和TIVA(T组)。麻醉前通过喉部检查进行语音记录。围手术期血流动力学参数,记录气道并发症和术后气道并发症。在麻醉程序后24小时后第二次进行喉部检查和语音记录。通过Praat程序评估患者的声音分析。包括喉咙痛,吞咽困难,麻醉后检查声音嘶哑。声音的声学和空气动力学特性,在患者中比较了与使用SAD相关的气道并发症和咽喉主诉。
结果:两组人口统计学数据之间没有任何显著差异。SAD类型和大小具有相似的特征。T组和D组麻醉时间差异无统计学意义(P=0.964)。两种麻醉方法对咽喉功能和声音产生相似的影响。除了声学分析的闪烁值之外,T组和D组之间的参数没有显着差异。在D组的Shimmer变量中观察到统计学上显著的增加(P<0.05)。T组和D组比较,在气道并发症方面没有任何显著差异,喉咙痛,吞咽困难,和声音嘶哑。
结论:TIVA和地氟醚麻醉在通过SAD的短期妇科手术中对嗓音和咽喉发病率具有相似的临床效果。D组声音分析的闪烁值增加表明地氟醚麻醉可能会引起临床上声音的轻微恶化。需要进一步的全面研究以证明麻醉剂对使用SAD的患者的喉功能的影响。
OBJECTIVE: Supraglottic airway devices (SADs) are a good alternative to endotracheal intubation (ETI) in short-term anesthesia applications since they have advantages including easy application, lower cost, enabling spontaneous ventilation. Total intravenous anesthesia (TIVA) and desflurane anesthesia allowing rapid recovery are anesthesia methods to be selected. Inhalation anesthesia by desflurane may cause adverse effects on airway mucosa and vocal cord functions. The aim of the present study was to compare the effect of the chosen anesthesia method on voice in gynecological patients who underwent short-term anesthesia with SADs.
METHODS: Seventy four patients whom short-term surgical procedure was planned in the Gynecology and Obstetrics Clinic were randomized into two groups for desflurane anesthesia (group D) and TIVA (group T). Voice recording was performed through larynx examination before anesthesia. Perioperative hemodynamic parameters, airway complications and postoperative airway complications were recorded. Laryngeal examination and voice recording were performed for the second time after 24 hours following the anesthesia procedure. Acoustic voice analysis of the patients was evaluated through the Praat program. The conditions including sore throat, dysphagia, and hoarseness were investigated after the anesthesia. Acoustic and aerodynamic properties of the voice, airway complications and pharyngolaryngeal complaints related to the use of SADs were compared in the patients.
RESULTS: There was not any significant difference between the groups for demographic data. The SADs type and size have similar characteristics. No significant difference was detected between Group T and Group D for anesthesia duration (P = 0.964). Both anesthesia methods cause similar effects on pharyngolaryngeal functions and voice. No significant difference was found between Group T and Group D in parameters other than the shimmer value of acoustic analysis. A statistically significant increase was observed in the Shimmer variable of group D (P < 0.05). When group T and group D were compared, there was not any significant difference in terms of airway complications, sore throat, dysphagia, and hoarseness.
CONCLUSIONS: The TIVA and desflurane anesthesia presented similar clinical effects on voice and pharyngolaryngeal morbidity in the short-term gynecological operations through SADs. The increased shimmer value of acoustic voice analysis in Group D suggests that desflurane anesthesia may cause clinically insignificant deterioration on the voice. Further comprehensive studies are needed in order to demonstrate the effect of anesthetic agents on larynx functions in patients whom SADs is used.