Síndrome disfônica ocupacional: novos aspectos desta entidade nosológica / Dysphonic occupational syndrome: new aspects of this nosological entity

Introdução: Professores apresentam frequentemente disfunções fonatórias que se beneficiam de medidas preventivas. Objetivo: Determinar a prevalência da síndrome disfônica em professores e verificar a evolução deste índice com técnicas de prevenção primária. Método: Foi realizado um estudo de corte transversal em professores em duas épocas distintas: na fase 1 participaram 101 professores e, na fase 2, 148 professores. A estes dois grupos foi aplicado o questionário elaborado pela Comissão Tripartite de Normatização da Voz Profissional. Resultados: A prevalência da síndrome disfônica na primeira fase foi de 70,3%, enquanto que na segunda fase foi de 57,59%. Conclusão: 1ª a prevalência da síndrome disfônica sofreu redução significativa com a implementação do controle médico preventivo e da organização do trabalho. 2ª a síndrome disfônica é uma nova entidade nosológica. Estudo epidemiológico de corte transversal. Estudo de série.

Introduction: Teachers often have vocal disorders that benefit from preventive measures. Objective: To determine the prevalence of the syndrome in dysphonic teachers and check the evolution of this index with the techniques of primary prevention. Method: We performed a cross-sectional study of teachers in two different periods: in the first 101 teachers and participated in phase 2, 148 teachers. These two groups was administered the questionnaire prepared by the tripartite commission on regulation of the professional voice. Results: The prevalence of the syndrome dysphonic in the first phase was 70.3%, while the second stage was 57.59%. Conclusion: 1st dysphonic the prevalence of the syndrome was significantly decreased with the implementation of preventive and medical control of work organization. 2nd dysphonic syndrome is a new nosological entity. Cross-sectional epidemiological study. Study series.

[ comparison of beclomethasone inhaler and intravenous lidocaine in prevention of postoperative airway and throat complaints]

Tracheal intubation can result in trauma and nerve damage which may also account for postoperative throat symptoms such as hoarseness and dysphagia. The effects of beclomethasone inhaler and intravenous lidocaine in prevention of the above symptoms were documented in previous studies. The aim of the present study is comparison of the effects of beclomethasone inhaler with various clinically used dosages of intravenous lidocaine prior to endotracheal intubation on the incidence and severity of postoperative sore throat, cough, sputum, hoarseness, and dysphagia. A total of 120 patients undergoing elective operations were enrolled in this randomized double-blind clinical trial. Patients were assigned to one of four treatment modalities: lidocaine 1mg/kg [group L[1]], lidocaine 1.5 mg/kg [group L[2]], a dose of 50 micrograms beclomethasone inhaler [Group B], and normal saline [Group C]. Incidence and severity of sore throat, cough, sputum, hoarseness, and dysphagia were compared between the groups before leaving the operating room, 1 hr later, at the time of the first postoperative drink or meal [for assessment of dysphagia], and in the morning after the surgery. In all time intervals of evaluating postoperative symptoms, the incidence and severity of sore throat were significantly lower in groups L2 and B than in group C [P <0.05]. One and twenty hours after emergence of anesthesia, the incidence and severity of cough were significantly lower in groups L[2] and B than in group C [P <0.05]. The incidence and severity of sore throat or cough was not significantly different between groups L2 and B. Throughout the study, the incidence and severity of sputum were significantly lower in group B than in group C [P <0.05]. Beclomehtasone in comparison with intravenous lidocaine prior to intubation decreases the postoperative sore throat and cough. In addition, beclomethasone inhaler decreases the incidence and severity of postoperative sputum

effect of betamethasone gel in reducing sore throat, cough, and hoarseness after laryngo-tracheal intubation

Tracheal intubation for general anesthesia often leads to traumatization of the airway mucosa resulting in postoperative sore throat, hoarseness and cough. This study was undertaken to determine the effects of betamethasone gel in reducing these complications. One hundred patients [ASA I-II] to undergo endotracheal intubation, were randomly divided equally into two groups; 50 Case [Group A]. 50 Control [Group B]. The tracheal tubes for Case Group A were lubricated with 0.05% betamethasone gel and for the Control Group B with KY gel. Patients were interviewed at end of procedures and 1 and 24 hour after extubation. The incidence and severity of sore throat, hoarseness and cough, 1 and 24 hours postoperatively was reduced significantly in Case Group A. Betamethasone gel, when was used for lubrication of endotracheal tubes pre-operatively, was shown to be effective in decreasing postoperative sore throat, hoarseness, and cough

effect of local heat on incidence of sore throat and hoarseness after endotracheal intubation

Sore-throat and hoarseness are the most common complication after endotracheal intubation which take place 12-24 hr after operation. Different studies have reported the incidence of these complications between 24-90%. Increase of heat on the trachea will raise the blood pressure in the local capillaries and therefore induce better blood supplementation to the local tissues. This study aimed to evaluate the effect of local heat on the incidence of sore- throat and hoarseness after endotracheal intubations. One hundred and sixty patients aging 15 -50 years old, candidate for elective surgeries under general anesthesia, were randomly divided into two groups. Patients for head and neck surgeries were excluded from the study. Methods of intubation, type, size, cuff pressure of ETT, method of anesthesia and time of operation were the same for all patients. During the operation time, local heat was applied on the external surface of trachea [up to 40 [oc] by using electrical blanket for the patients in the study group. 24 hr after operation all the patients were visited by anesthesiologist for evaluating the sore- throat and hoarseness. The incidence of sore-throat in the control group was 65% versus 40% in the study group [p<0.05]. Moreover the incidence of hoarseness was 66.2% in the control group versus 10% in the case group. Application of local heat [40[oc] on the external surface of trachea can effectively decreases the incidence of postoperative sore - throat and hoarseness

Effectiveness of lubrication of endotracheal tube cuff with chamomile-extract for prevention of postoperative sore throat and hoarseness.

PURPOSE OF THE STUDY: To determine the efficacy of lubrication of the endotracheal tube cuff with Chamomile extract (Kamillosan M) before intubation on postoperative sore throat and hoarseness. MATERIAL AND METHOD: The authors randomly assigned 161 patients ASA (American Society of Anesthesiologists) physical status I, II elective surgical, orthopedic, gynecological or urological into 2 groups. The study group received 10 puffs of total 370 mg of Chamomile extract (Kamillosan M spray) lubricated at cuff of endotracheal tube while the control group did not receive any lubrication before intubation. Standard general anesthesia with tracheal intubation was given in both groups. Sore throat and hoarseness were recorded in post anesthetic care unit and at 24 h after operation. RESULTS: One hundred and sixty-one ASA physical status I, II elective surgical patients were recruited. Forty one out of 81 patients (50.6%) in the Chamomile group, scored no postoperative sore throat in the post-anesthesia care unit compared with 45 out of 80 patients (56.3%) in the control group p=0.386. Postoperative sore throat and hoarseness both in the postanesthesia care unit and at 24 h postoperation were not statistically different. There was no statistically significant relationship between sore throat or hoarseness and postoperative nausea or vomiting, ASA physical status, gender, history of smoking, grade of laryngoscopic view, number of intubation attempts, condition during intubation, use of oral airway and couching during extubation. CONCLUSION: Lubrication of endotracheal tube cuff with Chamomile extract spray before intubation can not prevent post operative sore throat and hoarseness.

Endotracheal tube cuff using air or saline to prevent postoperative hoarseness and sore throat: a randomized controlled trial

To compare the frequency and severity of sore throat and hoarseness following inflation of the endotracheal cuff using air or saline. A double-blined, randomized controlled trial in 63 intubated patients was conducted at Queen Alia Military Hospital in 1999. Patients were included if they were ASA 1-3, aged 18 years or older scheduled for operation below the neck which were expected to last longer than one hour. Following placement of the tracheal tube, the cuff was inflated slowly [using air or saline], until no leak was felt and was connected to a three-way stopcock, extension tubing and connection to a pressure transducer. Intra-cuff pressures were compared to assess any change due to inward diffusion of nitrous oxide. The frequency of significant sore throat and/or hoarseness overall was 15%. There were no statistically significant difference between the groups [air 15%, saline 14.5%]. In the air group mean, intra-cuff pressure increased significantly [start 14 mmHg, end 40 mmHg], while in the saline group there was no significant increase [start 12.7 mmHg, end 14.6 mmHg]. The substitution of saline reliably results in sustained low intra-cuff pressure but high tracheal pressure, but is not an immportant factor in the development of sore throat or hoarseness postoperatively within the pressure range and duration of the operations

Efficacy of chamomile-extract spray for prevention of post-operative sore throat.

A randomized, double-blind study was carried out to assess the effect of 111 mg of Chamomile extract spray compared with normal saline spray (placebo) administered before intubation on post-operative sore throat and hoarseness. One hundred and sixty-one ASA (American Society of Anesthesiologists) physical status I, II elective surgical patients were recruited. Forty-two out of 80 patients (52.5%) in the Chamomile group scored no post-operative sore throat in the post-anesthesia care unit compared with 41 out of 81 patients (50.6%) in the placebo group, p=0.159. Post-operative sore throat and hoarseness both in the post-anesthesia care unit and 24 hour after operation were not statistically different. There was no statistically significant relationship between sore throat or hoarseness and ASA physical status, sex, history of smoking, grade of laryngoscopic view, number of intubation attempts, condition during intubation and condition of extubation. However, there was significant correlation between use of oral airway and sore throat in the post-anesthesia care unit and 24 hours after operation (p=0.031 and 0.002 respectively). Chamomile extract spray administered before intubation, therefore, can not prevent post-operative sore throat and hoarseness.