The Impact of Head Elevation on Preventing Emergence Cough during Endotracheal Extubation in Male Patients
- 주제(키워드) emergence cough , head elevation , male , remifentanil
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 김지은
- 발행년도 2024
- 학위수여년월 2024. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000034055
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background : Emergence cough during endotracheal extubation can cause complications. This cough occurs when the endotracheal tube deviates from the airway anatomy, applying pressure to the airway's mucosal wall. Head elevation may help align the airway with the tube's position. This study aims to examine the effect of using a pillow for head elevation on the prevalence and severity of emergence cough in male patients. Material/Methods : A total of 71 male patients undergoing laparoscopic cholecystectomy were randomly divided into two groups: the head elevation group (n=35) and the control group (n=36). The head elevation group maintained a neck flexion angle of 35º using a pillow, while the control group remained in a neutral position following anesthetic induction. Cough severity was evaluated before, during, and after extubation using a 4-point scale, where grades 2 and 3 indicated coughing, with grade 3 signifying severe cough. Results : Patient’s characteristics and intraoperative data were comparable. The incidences of cough and severe cough did not differ significantly between the two groups. However, the severity of cough before extubation was significantly lower in the head elevation group compared to the control group (cough scale: 0/5/8/23 in the control group vs 1/2/17/15 in the head elevation group, P=0.039). Time to extubation, respiratory complications, nausea and vomiting, overall and throat pain, and the number of patients receiving the fentanyl as rescue were similar. Conclusions : Using a pillow to elevate the head effectively reduced the severity of cough before endotracheal extubation during anesthesia emergence in male patients. However, it did not significantly decrease the incidence of cough. These findings underscore the potential benefits of head elevation in reducing the discomfort associated with emergence cough. Keywords : emergence cough, head elevation, male, remifentanil Abbreviation : PACU (postanesthesia care unit), HR (heart rate), MAP (mean arterial pressure)
more목차
Ⅰ. Introduction 1
Ⅱ. Material and Method 3
A. Ethics Statement 3
B. Patient Allocation 3
C. Anesthesia 3
D. Definition and Measurements 4
E. Statistical Analysis 5
Ⅲ. Results 6
A. Cough Profiles 6
B. Emergence and Recovery Profiles 6
C. Hemodynamics 6
IV. Discussion 7
Ⅴ. Conclusions 11
Ⅵ. List of Figures 12
A. Patient enrollment 12
B. The heart rate and mean arterial pressure during perioperative period 13
Ⅶ. List of Tables 14
A. Characteristics and intraoperative data of male patients 14
B. Incidence and severity of cough 15
C. Anesthetic emergence and recovery outcomes 16
Ⅷ. References 17
