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Gender differences in risk factors for airway symptoms following tracheal intubation
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-7574-6745
Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-6128-7752
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden; Centre of Health Care Sciences, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5403-4183
2012 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 56, no 10, p. 1306-1313Article in journal (Refereed) Published
Abstract [en]

Background: A common complaint after endotracheal intubation is sore throat and hoarseness. The aim of this study was to describe gender differences and independent risk factors in the development of post-operative sore throat and hoarseness after endotracheal intubation in adults.

Methods: This prospective cross-sectional observational study was conducted at a university hospital in Sweden. A total of 495 patients were included (203 men and 292 women) and enrolled from a total of eight different surgical departments. Outcome variables were post-operative sore throat and hoarseness evaluated post-operatively in the post-anaesthesia care unit. A total of 31 variables were recorded which described the intubation process, intraoperative factors as well as the extubation process. Bivariate and multivariate analyses were performed.

Results: The overall incidence of post-operative sore throat was 35% and hoarseness 59%. The results show different predictors for men and women in the development of airway symptoms. The main risk factor for developing sore throat in men was intubation by personnel with <?3 months' work experience. In women, it was endotracheal tube size 7.0 and multiple laryngoscopies during intubation. The main risk factors for hoarseness were cuff pressure for both men and women, and oesophageal temperature probe in women.

Conclusion: Post-operative sore throat and hoarseness result from several factors, and the cause of these symptoms are multifactorial and differs by gender. Identification of these factors pre-operatively may increase awareness among anaesthesia personnel and possibly reduce the incidence of these minor but distressing symptoms.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2012. Vol. 56, no 10, p. 1306-1313
Keywords [en]
Adult, Age Factors, Aged, Anesthesia Inhalation, Cross-Sectional Studies, Female, Hoarseness, Humans, Intubation Intratracheal, Laryngoscopy, Logistic Models, Male, Middle Aged, Multivariate Analysis, Pharyngitis, Postoperative Complications, Prospective Studies, Risk Factors, Sex Factors
National Category
Medical and Health Sciences Nursing Anesthesiology and Intensive Care
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-26523DOI: 10.1111/j.1399-6576.2012.02771.xISI: 000309714000013PubMedID: 22998099Scopus ID: 2-s2.0-84867582026OAI: oai:DiVA.org:oru-26523DiVA, id: diva2:572243
Available from: 2012-11-27 Created: 2012-11-27 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, MariaGupta, AnilNilsson, Ulrica

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