전신 마취를 위한 기관내 삽관이 술 후 음성 변화에 미치는 영향과 관여 인자
Effects and Related Factors of Endotracheal Intubation on Voice Change Following General Anesthesia
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Background and Objectives Reliable studies about the impact of short-term intubation, particularly as part of general anesthesia, are scarce. That scarcity led to the following research objectives. First of all, we tried to find out how often and why voice change last more than 72 hours after intubation conducted for general anesthesia. Subjects and Method The study enrolled 80 patients who were due to undergo general anesthesia at the Seoul Paik Hospital from Aug. 2009 to May 2010. The patients were examined through stroboscopic examination and voice analysis before surgery. Three days after the surgery, the same tests were performed again to single out patients whose results were abnormal; thus a proportion could be calculated. The other objective was to determine the factors involved with voice change. This was done according to the Mallampati classification, using the images from laryngoscopy and compiling records of cuff pressure, cuff volume, tube size, duration of intubations, and the number of intubation trials. Results 7.5% of the patients suffered from voice change longer than 3 days. Three factors, namely, cuff pressure, duration of anesthesia and patient age demonstrated statistically significant relationships among them. Conclusion The results indicate that there is a need for patients scheduled to face general anesthesia to receive sufficient explanation about the possible postoperative voice change that could last longer than 3 days. Furthermore, surgeons and anesthesiologists need to cooperate closely by taking the patient age, duration of anesthesia and cuff pressure into account in order to limit postoperative voice change to the minimum extent.
Abstract
Background and Objectives Reliable studies about the impact of short-term intubation, particularly as part of general anesthesia, are scarce. That scarcity led to the following research objectives. First of all, we tried to find out how often and why voice change last more than 72 hours after intubation conducted for general anesthesia. Subjects and Method The study enrolled 80 patients who were due to undergo general anesthesia at the Seoul Paik Hospital from Aug. 2009 to May 2010. The patients were examined through stroboscopic examination and voice analysis before surgery. Three days after the surgery, the same tests were performed again to single out patients whose results were abnormal; thus a proportion could be calculated. The other objective was to determine the factors involved with voice change. This was done according to the Mallampati classification, using the images from laryngoscopy and compiling records of cuff pressure, cuff volume, tube size, duration of intubations, and the number of intubation trials. Results 7.5% of the patients suffered from voice change longer than 3 days. Three factors, namely, cuff pressure, duration of anesthesia and patient age demonstrated statistically significant relationships among them. Conclusion The results indicate that there is a need for patients scheduled to face general anesthesia to receive sufficient explanation about the possible postoperative voice change that could last longer than 3 days. Furthermore, surgeons and anesthesiologists need to cooperate closely by taking the patient age, duration of anesthesia and cuff pressure into account in order to limit postoperative voice change to the minimum extent.
참고문헌 (17)
- McGovern FH, "The hazards of endotracheal intubation", Ann Otol Rhinol Laryngol, 80(4), pp.556~564 (1971)
- Hedden M, "Laryngotracheal damage after prolonged use of orotracheal tubes in adults", JAMA, 207(4), pp.703~708 (1969)
- Weymuller EA Jr, "Problems associated with prolonged intubation in the geriatric patient", Otolaryngol Clin North Am, 23(6), pp.1057~1074 (1990)
- Hamdan AL, "Short-term effects of endotracheal intubation on voice", J Voice, 21(6), pp.762~768 (2007)
- Nam SY, "Acoustical effects of short-term endotracheal intubation", Korean J Otolaryngol-Head Neck Surg, 42(10), pp.1295~1299 (1999)
- Mallampati SR, "Clinical sign to predict difficult tracheal intubation (hypothesis)", Can Anaesth Soc J, 30 (1983)
- Cormack RS, "Difficult tracheal intubation in obstetrics", Anaesthesia, 39(11), pp.1105~1111 (1984)
- Beckford NS, "Effects of shortterm endotracheal intubation on vocal function", Laryngoscope, 100(4), pp.331~336 (1990)
- Balestrieri F, "Intubation granuloma", Otolaryngol Clin North Am, 15(3), pp.567~579 (1982)
- Loucks TM, "The vocal athlete and endotracheal intubation:a management protocol", J Voice, 12(3), pp.349~359 (1998)
- Stout DM, "Correlation of endotracheal tube size with sore throat and hoarseness following general anesthesia", Anesthesiology, 67(3), pp.419~421 (1987)
- Donnelly WA, "Local sequelae of endotracheal anesthesia", Anesthesiology, 9(11), pp.490~497 (1948)
- Bishop MJ, "Mechanisms of laryngotracheal injury following prolonged tracheal intubation", Chest, 96(1), pp.185~186 (1989)
- Weymuller EA Jr, "Quantification of intralaryngeal pressure exerted by endotracheal tubes", Ann Otol Rhinol Laryngol, 92(5 Pt 1), pp.444~447 (1983)
- Seegobin RD, "Endotracheal cuff pressure and tracheal mucosal blood flow:endoscopic study of effects of four large volume cuffs", Br Med J(Clin Res Ed), 288(6422), pp.965~968 (1984)
- Jensen PJ, "Sore throat after operation:influence of tracheal intubation,intracuff pressure and type of cuff", Br J Anaesth, 54(4), pp.453~457 (1982)
- Peppard SB, "Laryngeal injury following short-term intubation", Ann Otol Rhinol Laryngol, 92(4 Pt 1), pp.327~330 (1983)