Laryngeal mask airway reduces incidence of post-operative sore throat after thyroid surgery compared with endotracheal tube: a single-blinded randomized controlled trial

Abstract

BackgroundSore throat is a remarkable complication after thyroid surgery with endotracheal tube (ETT). Many studies revealed that laryngeal mask airway (LMA) might reduce the incidence and severity of postoperative sore throat. However, little is known about the use of a flexible reinforced LMA (FLMA) in thyroid surgery. The purpose of this study was to explore the potential benefits of FLMA compared with ETT on postoperative sore throat.MethodsIn this prospective, single-blinded, randomized, controlled trial, ninety-six patients aged 20-80 years, scheduled for elective radical thyroidectomy under general anesthesia were enrolled. They were randomly divided into ETT group and FLMA group. All the included patients received total intravenous anesthesia (with propofol, fentanyl and rocuronium) and controlled mechanical ventilation during the surgery. Cuff pressure of ETT and FLMA were strictly controlled. Incidence and severity of postoperative sore throat, numbness and hoarseness at 1, 24, and 48 h after surgery was evaluated and compared between the two groups. Incidence and severity of buckling during extubation and the hemodynamic profile during intubation were also recorded and compared.ResultsThe incidence of sore throat and hoarseness was significantly lower in FLMA group than those in ETT group at 1h, 24h and 48h postoperatively, as well as the severity of sore throat. Compared to ETT group, there was a significantly lower incidence of buckling during extubation and less fluctuation of HR and BP at 1min and 3min after intubation in FLMA group.ConclusionsPostoperative sore throat and hoarseness was improved in patients undergoing thyroid surgery with FLMA when compared with ETT. The use of FLMA also achieved less buckling during extubation and better hemodynamic profiles during intubation.

Risk Factors for Acute Postoperative Sort Throat (POST) After Supraglottic Device Use 

“…Second, the incidence of POST was assessed only at discharge from the PACU. POST may persist for 2 to 3 days and require additional attention from healthcare providers [26]. However, Seet et al found that the incidence of POST was low (3.1%) in their pressure-limiting group at 24 hours postoperatively [4].…”

“…It affects patient satisfaction and can in uence activity after discharge. SADs offers an alternative to traditional tracheal intubation, with the potential bene t of reducing the risk of sore throat [5][6][7]. However, the overall incidence of POST after using an SAD can be as high as 42% [8].…”

Prevalensi Nyeri Tenggorok Pascaoperasi dengan Pemberian Lubrikasi VCO pada Pemasangan LMA

“…Beberapa penelitian menyimpulkan bahwa kandungan asam lemak dalam VCO berpotensi untuk dikembangkan sebagai analgetik, antipiretik, antiinflamasi [10][11][12][13] , sebagai obat untuk menyembuhkan luka bakar, antimikroba, 14 sebagai pelembab untuk melindungi kulit dan mencegah kulit kering, 15 sebagai pelumas untuk mengurangi efek gesekan dan geseran. 16 Manfaat Sehingga keberhasilan pemasangan juga dapat mempengaruhi kejadian nyeri 6,18,20,19,[21][22][23][24][25] Pada jam ke-0 pascaoperasi penelitian ini mendapatkan hasil prevalensi nyeri tenggorok pascaoperasi sebesar 47,6%, Gong et al mendapatkan hasil sebesar 48,5%, dengan menggunakan LMA tanpa lubrikasi. 19 Kiran et al mendapatkan hasil 0% dengan menggunakan LMA yang dilubrikasi dengan betametason gel 0,05% dan 53,3% dengan LMA yang dilubrikasi dengan jeli lignokain 2%.…”

“…16 Manfaat Sehingga keberhasilan pemasangan juga dapat mempengaruhi kejadian nyeri 6,18,20,19,[21][22][23][24][25] Pada jam ke-0 pascaoperasi penelitian ini mendapatkan hasil prevalensi nyeri tenggorok pascaoperasi sebesar 47,6%, Gong et al mendapatkan hasil sebesar 48,5%, dengan menggunakan LMA tanpa lubrikasi. 19 Kiran et al mendapatkan hasil 0% dengan menggunakan LMA yang dilubrikasi dengan betametason gel 0,05% dan 53,3% dengan LMA yang dilubrikasi dengan jeli lignokain 2%. 25 Hasil penelitian ini lebih baik dibandingkan dua penelitian di atas, tetapi tidak lebih baik bila dibandingkan dengan lubrikan betametason gel 0,05%.…”

“…Penelitian Intahphuak et al juga menyatakan bahwa VCO mulai bekerja sebagai analgetik dan anti inflamasi pada menit ke 60. 11 Nyeri tenggorok pascaoperasi pada jam ke-24 diamati pada banyak penelitian, diantaranya Dingley et al mendapatkan prevalensi nyeri tenggorok pascaoperasi sebesar 28,5%, 20 Gong et al sebesar 37,8%, 19 Venugopal et al sebesar 23,5%, 22 Helmite et al sebesar 23,9%, 24 Purba et al sebesar 22,6%. 23 Penelitian di atas dilakukan dengan menggunakan LMA yang tidak diberi lubrikasi, sehingga terlihat bahwa prevalensi nyeri tenggorok lebih tinggi dibandingkan dengan hasil yang diperoleh dari penelitian ini.…”