静脉注射利多卡因、地塞⽶松及两者联合使⽤对患者术后咽喉痛的影响：随机对照试验
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Effect of Intravenous Lidocaine, Dexamethasone, and Their Combination on Postoperative Sore Throat: A Randomized Controlled Trial
背景与目的
术后咽喉痛（POST）、声⾳嘶哑及咳嗽等⽓管插管相关并发症⼗分常⻅。虽然利多卡因和地塞⽶松都已分别⽤来减少这些并发症，但尚⽆研究报道利多卡因和地塞⽶松联合应⽤的效果。
方 法
本项前瞻双盲随机对照研究纳⼊了180例需要⽓管插管全麻且麻醉时间>90min的患者。麻醉诱导前予这些患者静脉注射4种药物中的其中⼀种：L组注射利多卡因1.5 mg/kg，D组注射地塞⽶松8 mg，DL组注射利多卡因1.5 mg/kg和地塞⽶松8 mg，NS组注射普通⽣理盐⽔作为安慰剂。随后按标准麻醉⽅案诱导。评估术后24h咽喉痛、咳嗽、声⾳嘶哑的发⽣率和严重程度。术后咽喉痛的发⽣率作为主要结果，重点观察地塞⽶松和利多卡因的主要效果。
结 果
D组患者45例，L组44例，DL组44例，NS组43例。D组、L组、DL组和NS组咽喉痛的发⽣率分别是36%、43%、 25%和56%(P =0.02)。地塞⽶松加或不加利多卡因均可降低术后咽喉痛的发⽣率（⽐值⽐0.44；95%CI：0.24–0.82；P <0.01）。然⽽，利多卡因不能有效减少术后咽喉痛的发⽣（⽐值⽐ 0.62；95%CI: 0.33–1.14; P =0.12）。各组间咽喉痛的严重程度，咳嗽的发⽣率和严重程度，以及声⾳嘶哑并⽆差异。
结 论
⽆论是否联合应⽤利多卡因，地塞⽶松均可有效降低需⻓时间⽓管插管患者术后咽喉痛的发⽣率。
原始文献摘要
Asish S,Mukesh T ,Krishna P,et al.Effect of Intravenous Lidocaine,Dexamethasone, and Their Combination on Postoperative Sore Throat:A Randomized Controlled Trial[J].Anest hesia and analgesia，2018 Oct 12.
Background:Postoperative sore throat (POST), hoarseness, and cough after tracheal intubation are not uncommon. Although both lidocaine and dexamethasone have been used independently to reduce these events, there is no study assessing the combined effects of lidocaine and dexamethasone.
Methods: This prospective, double-blind, randomized controlled study enrolled 180 patients requiring general anesthesia with endotracheal intubation for >90minutes. They received 1 of the 4 intravenous agents just bef ore induction of anesthesia: lidocaine (1.5 mg/kg) in group L, dexamethasone (8 mg) in group D, lidocaine (1.5 mg/kg) with dexamethasone (8mg) in group DL, and placebo as normal saline in group NS. Standard anesthesia protocol was followed. Incidence and severity of a sore throat, cough, and hoarseness of voice were assessed up to 24 hours postoperatively. The primary outcome was the incidence of POST, and the main eff ects of dexamethasone and lidocaine were the primary interest.
Results:Data of 45 patients in D, 44 in L, 44 in DL, and 43 in NS groups were analyzed. The incidence of a sore throat was 36%, 43%, 25%, and 56% in group D, L, DL, and NS, respectively (P = .02). Dexamethasone with or without lidocaine
reduced the incidence of the POST (odds ratio, 0.44; 95% confidence interval,0.24–0.82; P < .01). However, lidocaine was not effective in reducing POST (odds ratio, 0.62; 95% confidence interval, 0.33–1.14; P = .12). No difference was observed in the severity of a sore throat, incidence and severity of a cough, and hoarseness among the groups.
Conclusions:Dexamethasone, with or without lidocaine, was effective in reducing the incidence of POST in patients requiring prolonged tracheal intubation.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
编辑：李华宇 审校：代东君