Evaluation of the effects of tracheal spray (dexmedetomedine with and without ropivacaine) on post-intubation noise violence in major surgery

Abstract

In long-term surgeries, the tracheal tube remains inside the trachea for a long time, and this leads to an increase in the risk of voice harshness, and there is no similar study in Iran regarding the effectiveness of the combination of dexmedetomidine with rovacaine on reducing the prevalence of voice harshness. After extubation, the present study was conducted with the aim of investigating the effects of tracheal spray using dexmedetomidine with and without ropivacaine on voice severity after intubation in major surgery. Methods: This clinical trial study was conducted with the participation of 120 patients who were candidates for major surgeries (requiring endotracheal intubation) during 2023-24 at Imam Reza Hospital in Tabriz. A solution was prepared for all patients; The solution prepared for the dexmedetomidine group was 1 μg/kg, for patients in the ropivacaine group, the prepared solution was equal to 40 mg of ropivacaine concentration of 0.8%, for the patients in the dexmedetomidine + ropivacaine group, 1 μg/kg of dexmedetomidine plus 40 The mg of ropivacaine was 0.8% and the control group patients had normal saline serum. The volume of liquid for each group was 2 to 4 cc and it was prepared inside a syringe, and after three minutes of the injection of the relaxant, laryngoscopy was performed and the entire solution of the patient's trachea and mucus was sprayed, then another two minutes of ventilation with the mask was applied and then intubation was performed. Finally, hoarseness and hoarseness were measured at different times after surgery. Results: mean ± standard deviation of voice harshness during discharge from recovery for patients in the dexmedetomidine group equals 1.41±0.28, for patients in the ropivacaine group equals 1.69±0.29, for patients in the dexmedetomidine + ropivacaine group equals 0.12 ±1.12 and for the patients in the control group it was 1.0±89.33, the voice severity in the dexmedetomidine + ropivacaine group was ˃ voice severity in the dexmedetomidine group ˃ voice severity in the ropivacaine group ˃ voice severity in the control group (0.048= P); The mean ± standard deviation of sore throat during discharge from recovery for patients in the dexmedetomidine group was 1.63 ± 0.41, for patients in the ropivacaine group it was 1.85 ± 0.39, for patients in the dexmedetomidine + ropivacaine group it was 1.25 ± 0.14 And for the patients in the dexmedetomidine group, it was 2.09±0.55, which was sore throat in the dexmedetomidine + ropivacaine group, sore throat in the dexmedetomidine group, sore throat in the ropivacaine group, sore throat in the control group (P=0.043).