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Endotracheal tube size and sore throat following surgery: a randomized-controlled study
Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-7574-6745
Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences. Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden; Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5403-4183
2010 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 54, no 2, p. 147-153Article in journal (Refereed) Published
Abstract [en]

Background: Sore throat following endotracheal intubation is a common problem following surgery and one of the factors that affects the quality of recovery. This study was carried out with the primary aim of assessing whether the size of the endotracheal tube (ETT) affects the risk of sore throat in women following anaesthesia.

Methods: One hundred healthy adult women undergoing elective surgery were randomly allocated to oral intubation with either ETT size 6.0 or 7.0. Anaesthesia was based on either inhalation or total intravenous anaesthesia according to standardized routines. Pre- and post-operatively, sore throat and discomfort were assessed on a four-graded scale and for hoarseness on a binary scale (yes or no). Post-operatively, the assessments were performed after 1–2 and 24 h, and if there was discomfort at 24 h, a follow-up call was made at 72 and 96 h.

Results: After 1–2 h post-operatively, there were a higher proportion of patients with sore throat in ETT 7.0 vs. ETT 6.0 (51.1% vs. 27.1%), P50.006. This difference between the groups was also evident, P50.002, when comparing changes between the pre- and the post-operative values. The severity of discomfort from sore throat was also higher in ETT 7.0 (38.8%) compared with ETT 6.0 (18.8%), P 50.02. No differences were found in the incidence of hoarseness between the groups. The remaining symptoms lasted up to 96 h post-operatively in 11%, irrespective of the tube size.

Conclusion:Use of a smaller-sized ETT can alleviate sore throat and discomfort in women at the post-anaesthesia care unit.

Place, publisher, year, edition, pages
2010. Vol. 54, no 2, p. 147-153
Keywords [en]
Adult, Anesthesia Recovery Period, Anesthesia Intravenous, Anesthetics Intravenous, Anti-Inflammatory Agents Non-Steroidal, Antiemetics, Atracurium, Double-Blind Method, Equipment Design, Female, Fentanyl, Follow-Up Studies, Hoarseness, Humans, Intubation Intratracheal, Middle Aged, Narcotics, Neuromuscular Nondepolarizing Agents, Pain Measurement, Pharyngitis, Preanesthetic Medication, Propofol, Surface Properties, Surgical Procedures Elective, Time Factors
National Category
Anesthesiology and Intensive Care Nursing
Research subject
Nursing Science; Anaesthesiology
Identifiers
URN: urn:nbn:se:oru:diva-24529DOI: 10.1111/j.1399-6576.2009.02166.xISI: 000273448700005PubMedID: 19930246Scopus ID: 2-s2.0-74549185000OAI: oai:DiVA.org:oru-24529DiVA, id: diva2:545192
Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Postoperative sore throat and hoarseness: clinical studies in patients undergoing general anasthesia
Open this publication in new window or tab >>Postoperative sore throat and hoarseness: clinical studies in patients undergoing general anasthesia
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A common problem following general anesthesia is postoperative sore throat (POST) and postoperative hoarseness (PH). Symptoms directly correlated with less satisfaction according to the patients. The overall aim of this thesis was to describe patients' postoperative sore throat and hoarseness after general anesthesia with endotracheal intubation or laryngeal mask airway. As well as to investigate the risk factors that are associated with the symptoms, and to test methods that may prevent sore throat and hoarseness after a general anaesthetics. A total of 889 patients are included in the four studies. Incidence of POST varied from 21% up to 52 % depending on endotracheal tube (ETT) size in women (I-IV) and in men was the incidence 32-38% (III-IV). There were no gender difference in POST in study III and IV. The overall incidence of PH varied from 42- 59% (I-IV) in all patients, with no gender differences (III-IV). Following a laryngeal mask airway (LMA) 19% of the patients had POST and 33% of the patients reported PH. Patients with POST do seem to be able to localize their pain in the throat (IV). Different risk factors are shown to contribute to both POST and PH in men and women (II-III). To intubate with a smaller ETT size, 6.0 vs. 7.0 decreased POST in women in the early postoperative period as well as their discomfort from their POST (I). Only 6% of men who needed a laryngeal mask airway had POST compared to 26% of women. The symptoms are more discomforting after an ETT vs. an LMA up to 24 hours (IV). More patients have sore throat and hoarseness in the early postoperative period, but the symptoms can remain up to almost 5 days postoperatively (I, IV). In summary, sore throat and hoarseness following general anesthesia, affects many patients postoperatively. To intubate women with endotracheal size 6.0 decreases both sore throat and hoarseness postoperatively. Women are more likely than men to have a sore throat when a laryngeal mask airway is used.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 86
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 51
Keywords
hoarseness, postoperative, complication, endotracheal, tube, laryngeal mask airway, gender, risk factor.
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-31040 (URN)978-91-7668-975-2 (ISBN)
Public defence
2013-12-20, Wilandersalen, Örebro universitetssjukhus, S. Grev Rosengatan 18, 703 62 örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2017-10-17Bibliographically approved

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Jaensson, MariaNIlsson, Ulrica G.

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