Postoperativ halssmärta (POST) är en mycket vanlig komplikation hos patienter som genomgått generell anestesi med intubation.  POST anses av anestesipersonal vara en relativt lindrig komplikation. Patienter upplever det dock som ett stort problem och därför bör det undvikas. Syftet med denna litteraturstudie var att undersöka vad anestesisjuksköterskor kan göra för att förebygga POST som komplikation hos patienter som genomgått generell anestesi med intubation. Examensarbetet är en integrativ litteraturstudie som innefattar tolv globala studier. Litteraturstudiens resultat visar att det finns flera farmakologiska och icke farmakologiska metoder som kan förebygga POST. Lokal behandling med kortikosteroider och NSAID-preparat har förebyggande effekt på POST. Icke farmakologiska interventioner som konformad kuff, substanser som lakritslösning, magnesium och zink lindrar. Vissa studier finner att kortikosteroider och lidokain kan öka förekomsten av POST. I nuläget kan resultatet inte tillämpas av anestesisjuksköterskor då resultaten är tvetydiga och inte kan utföras utan ordination av anestesiolog. Vidare forskning inom området med inriktning på omvårdnad är av yttersta vikt.

Litteraturen beskriver larynxmask som ett skonsamt alternativ till intubation med endotrakealtub. Tidigare studier visar dock att det inte är ovanligt med halsbesvär postoperativt, i form av halsont och/eller heshet. Syftet med studien var att undersöka förekomst och karaktär av halsbesvär postoperativt efter användning av två olika larynxmasker. Författarna genomförde en pilotstudie där nitton vuxna patienter, både män och kvinnor, som erhållit Pro-Breathe® eller I-gel® larynxmask under anestesin ingick. Patienterna intervjuades 60 minuter respektive 24 timmar efter uttagandet av larynxmasken. Intervjun bestod av två slutna frågor om halsont och heshet samt en öppen fråga om hur det kändes i halsen. Den öppna frågan visade att andra typer av halsbesvär förekommer, bland annat irritabilitet, svårigheter att svälja, torrhet och svullnadskänsla. Pilotstudiens metod lämpade sig att använda och svarade mot studiens syfte. Resultatet visade att olika typer av halsbesvär var vanligt postoperativt. Åtta av tio patienter som haft Pro-Breathe® samt sju av nio patienter som haft I-gel® hade någon typ av halsbesvär. / The literature describes the laryngeal mask as a gentle alternative to intubation with endotracheal tube. Previous studies show that it is not unusual with throat discomfort postoperatively, in terms of sore throat and/or hoarseness/dysphonia. The aim of this study was to investigate the presence and nature of throat discomfort postoperatively after the use of two different laryngeal masks. The authors conducted a pilot study in which nineteen adult patients, both men and women, who received Pro-Breathe® or I-gel® laryngeal mask during anesthesia was included. The patients were interviewed 60 minutes and 24 hours after the laryngeal mask were removed. The interview consisted of two sealed questions about sore throat and hoarseness/dysphonia and one open question about how it felt in the throat. The open question showed that other types of throat discomforts occurred, including irritability, difficulty swallowing, dryness and swelling sensation. The method of the pilot-study was suitable to use and responded to the study's purpose. The results showed that different types of throat discomfort were common postoperatively. Eight out of ten patients who received Pro-Breathe® and seven out of nine patients who received I-gel® had some type of throat discomfort.

Bakgrund: Halsont och heshet är några av de vanligaste postoperativa komplikationerna hos patienter som erhållit endotrakealtub eller larynxmask under generell anestesi. Syfte: Att kartlägga anestesisjuksköterskans perioperativa åtgärder för att förebygga och lindra patientens postoperativa halsont och heshet. Metod: En litteraturöversikt med deskriptiv design. Resultat sammanställdes utifrån 18 granskade artiklar av kvantitativ ansats, eftersökta i databaserna PudMed och Cinahl. Resultat: Litteraturöversikten visade flertalet åtgärder som kunde minska både incidens och svårighetsgrad av postoperativ halsont och heshet. En mindre endotrakealtub, användning av kontinuerlig tryckregulator, administrering av glukokortikoider och användning av larynxmask gav minskad incidens av halsont och heshet. Även videolaryngoskop, minskad kraft vid extraktion av ledare och vissa naturläkemedel visade sig minska incidensen. Åtgärderna visade på goda effekter i nära anslutning till operationen och inom första postoperativa dygnet, emellertid gav få artiklar resultat med bibehållen effekt över tid. Slutsats: Studien gav goda indikationer för åtgärder som kunde minska patienters förekomst av halsont och heshet och därigenom deras lidande. Resultatet visade på stor spridning vilket gjorde det svårt bedöma vilka åtgärder som var lämpliga att applicera i kliniken. Att minska storleken på endotrakealtuben och använda larynxmask när operationen tillåter var åtgärder som ansågs användbara. Även användning av glukokortikoider/antiinflammatoriska läkemedel samt att i större utsträckning utnyttja videolaryngoskopstekniken ansågs som adekvata åtgärder för att minska patientens lidande orsakat av postoperativ halsont och heshet. / Background: Sore throat and hoarseness are some of the most common postoperative complications in patients receiving endotracheal tube or laryngeal mask during general anesthesia. Aim: To investigate the anesthetic nurse's perioperative measures to prevent and alleviate the patient's suffering from postoperative sore throat and hoarseness. Method: A literature review with descriptive design. Results were compiled based on 18 articles of quantitative approaches, requested in the databases PudMed and Cinahl. Result: The literature review showed several measures that could reduce both incidence and severity of postoperative sore throat and hoarseness. A minor endotracheal tube, the use of continuous cuff pressure regulator, administration of glucocorticoids and use of laryngeal mask reduced the incidence of sore throat and hoarseness. Also, video laryngoscopes, reduced force when extracting stylet removal and some herbal medications seemed to give good results in reducing the incidence. The measures showed good effects close to surgery and within the first postoperative day, however, few studies gave results with retained effect over time. Conclusions: The study provided good indications for measures that could reduce patients' incidence of sore throat and hoarseness and thereby their suffering. The results showed a large spread, which made it difficult to assess which measures were suitable for application in the clinic. Reducing the size of the endotracheal tube and using the laryngeal mask when the operation allows was implications that considered useful. Also, the use of glucocorticoids / anti-inflammatory drugs and to a greater extent utilizing the video laryngoscope technique was considered adequate measures to reduce the suffering of patients caused by postoperative sore throat and hoarseness.

<p>Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal.</p>

The purpose of this study was to compare the cost-effectiveness between the 2 types of general anesthesia, namely, laryngeal mask (LMA) and endotracheal intubation (ETT). The study included 353 patients who received general anesthesia during operation in a medical center in Kaohsiung City. Of these, 183 patients were assigned to the LMA group, while the remaining 170 were assigned to the ETT group. The norm of cost adopted by this study was calculated as the average expense per hour incurred by using the anesthetic and hygienic materials for medicinal use. The indices of effectiveness were physical reactions that were tracked at 2 h and 8¡V10 h postoperatively; these indices were acute pain, dizzyness, sore throat, nausea, and vomiting. These 5 indices were rated on a scale of 0¡V10. A low score was considered to represent lesser side-effects and greater effectiveness of the anesthetic. Besides, the shorter the recovery time of the patient was, the higher the effectiveness would be. The conclusion showed that the cost of the average expense per hour produced by the anesthesia and hygienic materials of medicinal use in the LMA group was 531 dollars while in the ETT group was 1,017 dollars. In the LMA group, at 2 h postoperatively, the mean tracking score for acute pain was 2.9 ¡Ó 2.6; for dizzyness, 1.4 ¡Ó 1.9; for sore throat, 0.4 ¡Ó 1.1; for nausea, 0.5 ¡Ó 1.4; and for vomiting, 0.2 ¡Ó 0.9. In the LMA group, at 8¡V10 h postoperatively, the mean tracking score for acute pain was 0.9 ¡Ó 1.5; for dizzyness, 0.6¡Ó1.3; for sore throat, 0.2 ¡Ó 0.7; for nausea, 0.1 ¡Ó 0.6; and for vomiting, 0.07 ¡Ó 0.4. In the ETT group, at 2 h postoperatively, the mean tracking score for acute pain was 4.9 ¡Ó 3.2; for dizzyness, 2.6 ¡Ó 2.5; for sore throat, 2.0 ¡Ó 2.1; for nausea, 1.3 ¡Ó 2.4; and for vomiting, 0.7 ¡Ó 1.9. In the ETT group, at 8¡V10 h postoperatively, the mean tracking score for acute pain was 2.82¡Ó 2.5; for dizzyness, 1.9 ¡Ó 1.9; for sore throat, 1.3 ¡Ó 1.9; for nausea, 1.1 ¡Ó 2.1; and for vomiting, 0.7 ¡Ó 1.9. The mean postoperative recovery time of the patients in the LMA group was 11.5¡Ó13.2 min and that for the patients in the ETT group was 25.9¡Ó16.0 min. T-test was performed to examine the hypothesis that LMA is more cost-effective than ETT when the same variables as those mentioned above are used; the results of all variables support the hypothesis that the p-value of every index was .000. Results of stepwise regression showed that LMA plays a significant positive role in every cost-effectiveness index.

<p>Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal.</p>

Magister Chirurgiae Dentium - MChD / Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal. / South Africa

Bakgrund Endotrakeal intubation används i många olika situationer där det finns ett behov av att skapa en säker luftväg. Den manipulation av luftvägarna som krävs i samband med en intubation kan bland annat orsaka postoperativ halssmärta och heshet, vilket kan ha negativa konsekvenser för patienten. För att försöka undvika komplikationer vid intubering har det utvecklats olika intubationshjälpmedel, där ett av hjälpmedlen är videolaryngoskop, som minskar den kraft som behövs för att skapa en fri insyn i larynx. Syfte Syftet med studien var att jämföra Macintosh direktlaryngoskopi mot McGrath videolaryngoskopi, för att undersöka om någon av metoderna ger minskad förekomst av halssmärta och heshet postoperativt. Metod För att besvara syftet antogs en kvantitativ ansats. Studien utfördes sedan som en förberedande undersökning med en induktiv metod. Datainsamlingen utfördes på en operationsavdelning i Västra Götaland, totalt deltog 24 patienter, varav 12 patienter intuberades med direktlaryngoskopi och 12 patienter intuberades med videolaryngoskopi. Deltagarna fick postoperativt svara på validerade enkätfrågor, och gradera eventuell förekomst av halssmärta och heshet enligt validerade fyrgradiga skalor. Resultat Resultatet visade att det eventuellt kan finnas en viss skillnad gällande postoperativ halssmärta beroende på om man intuberas med Macintosh direktlaryngoskopi eller McGrath videolaryngoskopi. Presenterat i absoluta och relativa mått visar det på att endast 1 deltagare (8%) som videolaryngoskoperades graderade lindrig halssmärta postoperativt, medan det var 3 deltagare (25%) som direktlaryngoskoperades som graderade lindrig halssmärta. Dock var skillnaden inte signifikant (p=0,56). Skillnaderna gällande heshet var större, där 9 deltagare (75%) som videolaryngoskoperades graderade sig helt besvärsfria postoperativt och 3 (25%) graderade en lindrig heshet. Ingen av deltagarna som direktlaryngoskoperades graderade sig som besvärsfri postoperativt, 9 (75%) graderade lindrig heshet och 3 (25%) graderade måttlig heshet. Skillnaden mellan grupperna var signifikant (p=0,001). Slutsats Skillnad verkar föreligga gällande framför allt heshet beroende på vilken intubationsmetod som används. Det kan även finnas en eventuell skillnad gällande halssmärta, dock är denna ej signifikant i pilotstudiens resultat. Studiepopulationen är begränsad i sitt antal, och det finns få studier att jämföra resultatet med. Det finns ett behov av fler och större studier för att finna evidens för den bästa metoden. / Background Endotracheal intubation is used in many different situations where there is a need to create a safe airway. The airway manipulation force that is required when an endotracheal intubation is needed may cause postoperative sore throat and hoarseness. This can adversely affect the patient. To avoid complications of an endotracheal intubation, different intubation aids have been developed, one of which is a videolaryngoscope, which reduces the force needed to create a free laryngeal insight. Aim The purpose of the study was to compare Macintosh direct laryngoscopy to McGrath videolaryngoscopy, to investigate whether either method reduces the incidence of sore throat and hoarseness postoperatively. Method To answer the purpose, a quantitative approach was adopted. The study was then conducted as a preliminary study with an inductive method. The data collection was carried out in an operation theatre in Västra Götaland, Sweden. A total of 24 patients participated, where 12 patients were intubated with direct laryngoscopy and 12 patients with videolaryngoscopy. Postoperatively the participants responded to validated questionnaires, and evaluated any occurrence of sore throat and hoarseness according to validated four-dimensional scales. Result There was a difference in postoperative sore throat depending on intubation with Macintosh direct laryngoscopy or McGrath videolaryngoscopy. Presented in absolute and relative terms, the result show that only 1 participant (8%) that was intubated with videolaryngoscopy graded mild sore throat postoperatively, while there 3 participants (25%) who were intubated with the use of direct laryngoscopy graded mild sore throat. However, the difference was not significant (p=0.56). The differences in hoarseness were greater, where 9 participants (75%) that was intubated with the use of videolaryngoscopy graduated no hoarseness post-operatively and 3 (25%) graded a mild hoarseness. None of the participants who were intubated with the use of direct laryngoscopy graded no hoarseness, 9 (75%) participants graded mild hoarseness and 3 (25%) graded moderate hoarseness. The difference between the groups was significant (p=0.001). Conclusions A difference exists in advance of hoarseness depending on the intubation method that is used. There may also be a difference regarding sore throat, but this result remained non-significant. However, in this pilot study the population was limited in its number, and there are few other studies in this field available for comparison. Therefore, more, and larger studies are needed to find evidence for the best intubation method.