[Effect of compound chamomile and lidocaine hydrochloride gel on oropharyngeal complications after the use of laryngeal mask airway with positive pressure ventilation].

Objective: To evaluate the effect of compound chamomile and lidocaine hydrochloride gel on oropharyngeal complications after the use of laryngeal mask airway with positive pressure ventilation. Methods: A total of 64 patients undergoing elective surgery under general anesthesia using laryngeal mask airway (LMA) with positive pressure ventilation in Beijing Tongren Hospital Affiliated to Capital Medical University From January to March 2023 were prospectively selected and divided into two groups by the random number table method: normal saline group (n=32), with 18 males and 14 females, aged 28-64 (48.4±10.6) years, and the compound chamomile and lidocaine hydrochloride gel group (chamomile gel group, n=32), with 18 males and 14 females, aged 24-64 (46.3±10.8) years. Patients in both groups received total intravenous anesthesia. Before LMA placement, the front, shoulder and back of LMA were lubricated with normal saline and compound chamomile and lidocaine hydrochloride gel in the normal saline group and the chamomile gel group, respectively. The main outcome measure was the incidence of postoperative oropharyngeal mucosal inflammation at different time points after the removal of the laryngeal mask. Secondary outcome measures included oropharyngeal mucositis score, sore throat score, hoarse voice score, cough score and throat dryness score at different time points after LMA removal, the number of LMA insertion times, time of successful insertion and leakage pressure, as well as stress reactions such as cough and agitation before and after LMA removal, and adverse reactions such as tongue numbness and protective pharyngeal reflex limitation during recovery. Results: The incidence of oropharyngeal mucositis in the chamomile gel group was 25.0% (8/32), 31.3% (10/32), 28.1% (9/32) and 3.1% (1/32) at 0.5, 3, 6 and 24 h after LMA removal, respectively, which were lower than those of normal saline group [53.1% (17/32), 59.4% (19/32), 59.4% (19/32) and 21.9% (7/32)] (all P<0.05). The oropharyngeal mucositis scores of patients in the chamomile gel group were 0 (0, 0.8), 0 (0, 1.0), 0 (0, 1.0) and 0 (0, 0) respectively at 0.5, 3, 6 and 24 h after LMA removal, which were lower than those in the saline group [1.0 (1.0, 1.8), 1.0 (0, 2.0), 1.0 (0, 2.0) and 0 (0, 0)] (all P<0.05). The cough score of the patients in the chamomile gel group was 0 (0, 0) and 0 (0, 0) at 3, 6 h after LMA removal, which were lower than those of the normal saline group [(0, 0) and 0 (0, 0)] (both P<0.05). The throat dryness score of the patients in the chamomile gel group was 0 (0, 1.0) at 3 h after LMA removal, which was lower than that of the normal saline group [1.0 (0.3, 1.0)] (P=0.019). The time of successful LMA insertion in the chamomile gel group was 25.0 (20.3, 29.8) s, which was shorter than that in the saline group [29.0 (25.0, 32.0) s] (P=0.016). There were no significant differences in the number of LMA insertion, leakage pressure, postoperative sore throat and hoarse voice scores between the two groups (all P>0.05). Likewise, there were no stress reactions such as cough and agitation before and after LMA removal, and no adverse reactions such as tongue numbness and limited protective pharyngeal reflex during recovery. Conclusion: Compound chamomile and hydrochloride lidocaine gel can reduce the incidence of postoperative oropharyngeal mucositis, relieve the symptoms of postoperative oropharyngeal mucositis, pharyngeal dryness and cough, and improve the postoperative comfort of patients using the laryngeal mask airway with positive pressure ventilation.目的： 评估复方甘菊利多卡因凝胶对喉罩正压通气患者术后口咽部并发症的影响。 方法： 前瞻性选取首都医科大学附属北京同仁医院2023年1至3月在全身麻醉喉罩正压通气下行择期手术的患者64例，采用随机数字表法分为2组：生理盐水组（n=32），男18例，女14例，年龄28~64（48.4±10.6）岁；复方甘菊利多卡因凝胶组（简称甘菊凝胶组，n=32），男18例，女14例，年龄24~64（46.3±10.8）岁。两组患者都采用全凭静脉麻醉，生理盐水组喉罩置入前，对喉罩的前、肩、背部进行生理盐水润滑处理，甘菊凝胶组使用复方甘菊利多卡因凝胶润滑处理。主要观察指标为喉罩拔除后0.5、3.0、6.0、24.0 h不同时间点的术后口咽黏膜炎发生率；次要观察指标包括喉罩拔除后不同时间点的口咽黏膜炎评分、咽喉痛评分、声音嘶哑评分、咳嗽评分和咽干评分，喉罩置入次数、成功置入用时和漏气压，拔除喉罩前后的呛咳、躁动等应激反应和苏醒期舌麻、保护性咽反射受限等不良反应发生率。 结果： 甘菊凝胶组患者的口咽黏膜炎发生率在喉罩拔除后0.5、3.0、6.0、24.0 h分别为25.0%（8/32）、31.3%（10/32）、28.1%（9/32）和3.1%（1/32），均低于生理盐水组的53.1%（17/32）、59.4%（19/32）、59.4%（19/32）和21.9%（7/32）（均P<0.05）。甘菊凝胶组患者的口咽黏膜炎评分［M（Q1，Q3）］在喉罩拔除后0.5、3.0、6.0、24.0 h分别为0（0，0.8）、0（0，1.0）、0（0，1.0）和0（0，0）分，均低于生理盐水组的1.0（1.0，1.8）、1.0（0，2.0）、1.0（0，2.0）和0（0，0）分（均P<0.05），甘菊凝胶组患者的咳嗽评分在喉罩拔除后3.0、6.0 h分别为0（0，0）、0（0，0）分，均低于生理盐水组的0（0，0）、0（0，0）分（均P<0.05），甘菊凝胶组患者的咽干评分在喉罩拔除后3.0 h为0（0，1.0）分，低于生理盐水组的1.0（0.3，1.0）分（P=0.019）；甘菊凝胶组患者喉罩成功置入用时25.0（20.3，29.8）s，低于生理盐水组的29.0（25.0，32.0）s（P=0.016）；两组患者的喉罩置入次数、漏气压、术后咽喉痛和声音嘶哑的评分差异均无统计学意义（均P>0.05）；两组患者均未见拔除喉罩前后的呛咳、躁动等应激反应和苏醒期舌麻、保护性咽反射受限等不良反应。 结论： 复方甘菊利多卡因凝胶用于全身麻醉喉罩正压通气手术患者，可降低术后口咽黏膜炎的发生率，减轻术后口咽黏膜炎、咽干和咳嗽的症状，提高患者术后的舒适度。.