The Effect of Cold Vapor on Intubation-Related Symptoms and Comfort in the Early Postoperative Period

NCT05317156 | Unknown

• 1 other identifier: IstanbulMU13
• Study Type: interventional
• Target: 120
• Locations: 0 countries
• Sites: N/A

Brief Summary

Endotracheal Intubation (EI) is performed in order to monitor the effectiveness of anesthesia and to control the patient's breathing during the surgery under general anesthesia. In EI, which is an invasive procedure, damage to the larynx and trachea may occur during the placement of the endotracheal tube or due to long-term use. Complications such as postintubation ulcer, laryngeal nerve paresis, arytenoid dislocation may develop in the early period due to EI, and patients may have complaints such as sore throat, swallowing problems, hoarseness, and cough in the postoperative period. This affects the comfort of the patients in the postoperative period. For this reason, it is important to prevent intubation-related symptoms of patients who will undergo surgical intervention before they occur.

Conditions

Intubation Complication; Cold; Sore Throat; Cough; Hoarseness; Dysphagia

Keywords

Intubation; Nursing care

Outcome Measures

Primary Outcomes (5)

• Cold vapor

  The sore throat, one of the intubation-related symptoms of the patients who underwent cold vapor, is decreased compared to those who do not. A score between 0 and 10 is taken from the Visual Analogue Scale (VAS). It is good that the score on the scales has decreased.

  First 24 hours after surgery

• Cold vapor

  The cough, one of the intubation-related symptoms of the patients who underwent cold vapor, is decreased compared to those who do not. A score between 0 and 4 is taken from the Cough Severity Form (CSF). It is good that the score on the scales has decreased.

  First 24 hours after surgery

• Cold vapor

  Swallowing, one of the intubation-related symptoms of the patients who underwent cold vapor, is decreased compared to those who do not. A score between 0 and 24 is taken from the Swallowing Impairment Score (SIS). It is good that the score on the scales has decreased.

  First 24 hours after surgery

• Cold vapor

  The hoarseness, one of the intubation-related symptoms of the patients who underwent cold vapor, is decreased compared to those who do not. A score between 0 and 3 is taken from the Shout's Hoarseness Scale (SHS). It is good that the score on the scales has decreased.

  First 24 hours after surgery

• Cold vapor

  The Perianesthesia Comfort Scale (PCS) of the patients for comfort who underwent cold vapor is decreased compared to those who do not. A score between 24 and 144 is taken from the PCS. It is good that the score from the PCS has increased.

  24th hour after surgery

Study Arms (4)

Prone position-Cold vapor group

EXPERIMENTAL

Cold vapor will be applied to the prone position experimental group patients for 15 minutes in the recovery room. For the study, Nebtime UN600A Ultrasonic Nebulizer Device will be used to apply cold steam to the patients which used in the hospital and calibrated (https://elmaslarmedikal.com.tr/urunler/nebtimeun600aultrasonik-nebulizator/). The parameters to be set on the device for the cold vapor to be applied to the patients in the early postoperative period will be vapor intensity level 5 (1-10), air blowing intensity 5 (1-10), heater intensity 1 (+10C), and timer 15 minutes. The patients will be evaluated by the researchers in terms of sore throat, cough, hoarseness, and dysphagia before and 15 minutes after the cold vapor application in the recovery room and at the 6th, 12th, and 24th hours after the cold vapor application in the postoperative service. In addition, the comfort levels of the patients will be evaluated at the 24th postoperative hour.

Other: Cold vapor

Supine position-Cold vapor group

EXPERIMENTAL

Cold vapor will be applied to the supine position experimental group patients for 15 minutes in the recovery room. For the study, Nebtime UN600A Ultrasonic Nebulizer Device will be used to apply cold steam to the patients which used in the hospital and calibrated (https://elmaslarmedikal.com.tr/urunler/nebtimeun600aultrasonik-nebulizator/). The parameters to be set on the device for the cold vapor to be applied to the patients in the early postoperative period will be vapor intensity level 5 (1-10), air blowing intensity 5 (1-10), heater intensity 1 (+10C), and timer 15 minutes. The patients will be evaluated by the researchers in terms of sore throat, cough, hoarseness, and dysphagia before and 15 minutes after the cold vapor application in the recovery room and at the 6th, 12th, and 24th hours after the cold vapor application in the postoperative service. In addition, the comfort levels of the patients will be evaluated at the 24th postoperative hour.

Other: Cold vapor

Prone position-Control group

NO INTERVENTION

Patients in the prone position control group will receive standard care that includes all medical and non-medical treatments in the hospital. Nursing care, which is routinely applied to patients in the postoperative period, both in the recovery room and in the service, will be continued within the standard care. The patients will be evaluated by the researchers in terms of sore throat, cough, hoarseness, and dysphagia when they come to the recovery room and at the 6th,12th, and 24th hours after the surgery in the postoperative service. In addition, the comfort levels of the patients will be evaluated at the 24th postoperative hour.

Supine position-Control Group

NO INTERVENTION

Patients in the supine position control group will receive standard care that includes all medical and non-medical treatments in the hospital. Nursing care, which is routinely applied to patients in the postoperative period, both in the recovery room and in the service, will be continued within the standard care. The patients will be evaluated by the researchers in terms of sore throat, cough, hoarseness, and dysphagia when they come to the recovery room and at the 6th,12th, and 24th hours after the surgery in the postoperative service. In addition, the comfort levels of the patients will be evaluated at the 24th postoperative hour.

Interventions

Cold vapor OTHER

Before surgery, the socio-demographic data of the patients will be recorded. After surgery, patients will be evaluated in the recovery room for their suitability to participate in the study with the Ramsay sedation scale and the Modified Aldrete Scale. Cold vapor will be applied to the patients for 15 minutes in the recovery room during the postoperative period. The parameters to be set on the device for the cold vapor to be applied to the patients in the early postoperative period will be vapor intensity level 5, air blowing intensity 5, heater intensity 1 (+10C), and timer 15 minutes. The patients will be evaluated by the researchers in terms of sore throat, cough, hoarseness, and dysphagia before and 15 minutes after the cold vapor application in the recovery room and at the 6th,12th, and 24th hours after the cold vapor application in the postoperative service. In addition, the comfort levels of the patients will be evaluated at the 24th postoperative hour.

Prone position-Cold vapor group; Supine position-Cold vapor group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being 18 years or older
• Having an ASA score of 1-2
• Not having any respiratory problems before the operation
• Not having a neurological disease related to swallowing
• Not having a sore throat due to cancer and chronic diseases
• Not having hoarseness before surgery
• With endotracheal intubation, the duration of the operation is at least 60 minutes under general anesthesia.
• Having surgery in one of the prone and supine positions
• Getting 2 points from the Ramsay Sedation Scale in the postoperative recovery room.
• Having a Modified Aldrete score of at least 9 in the postoperative recovery room
• To be willing to participate in the study.

You may not qualify if:

• To undergo emergency surgery
• Being under the age of 18
• Having an ASA score of 3 and above
• Having any respiratory problems in the preoperative period
• Having a neurological disease related to swallowing
• Having a sore throat due to cancer and chronic diseases
• Having throat surgery
• The duration of the operation is less than 60 minutes
• Having surgery in a position other than the prone and supine positions
• Not agreeing to participate in the study.

Sponsors & Collaborators

• Istanbul Medeniyet University: lead
• Maltepe University: collaborator

Related Publications (9)

• Bulut H, Erden S, Demir SG, Cakar B, Erdogan Z, Demir N, Ay A, Aydin E. The Effect of Cold Vapor Applied for Sore Throat in the Early Postoperative Period. J Perianesth Nurs. 2016 Aug;31(4):291-7. doi: 10.1016/j.jopan.2014.10.005. Epub 2016 Feb 24.

  PMID: 27444760 BACKGROUND

• Chang JE, Min SW, Kim CS, Han SH, Kwon YS, Hwang JY. Effect of prophylactic benzydamine hydrochloride on postoperative sore throat and hoarseness after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled trial. Can J Anaesth. 2015 Oct;62(10):1097-103. doi: 10.1007/s12630-015-0432-x. Epub 2015 Jul 7.

  PMID: 26149601 BACKGROUND

• Kim D, Jeon B, Son JS, Lee JR, Ko S, Lim H. The changes of endotracheal tube cuff pressure by the position changes from supine to prone and the flexion and extension of head. Korean J Anesthesiol. 2015 Feb;68(1):27-31. doi: 10.4097/kjae.2015.68.1.27. Epub 2015 Jan 28.

  PMID: 25664152 BACKGROUND

• Jung TH, Rho JH, Hwang JH, Lee JH, Cha SC, Woo SC. The effect of the humidifier on sore throat and cough after thyroidectomy. Korean J Anesthesiol. 2011 Dec;61(6):470-4. doi: 10.4097/kjae.2011.61.6.470. Epub 2011 Dec 20.

  PMID: 22220223 BACKGROUND

• Kim D, Jeong H, Kwon J, Kang S, Han B, Lee EK, Lee SM, Choi JW. The effect of benzydamine hydrochloride on preventing postoperative sore throat after total thyroidectomy: a randomized-controlled trial. Can J Anaesth. 2019 Aug;66(8):934-942. doi: 10.1007/s12630-019-01371-2. Epub 2019 Apr 16.

  PMID: 30993537 BACKGROUND

• Komasawa N, Mihara R, Imagawa K, Hattori K, Minami T. Comparison of Pressure Changes by Head and Neck Position between High-Volume Low-Pressure and Taper-Shaped Cuffs: A Randomized Controlled Trial. Biomed Res Int. 2015;2015:386080. doi: 10.1155/2015/386080. Epub 2015 Oct 5.

  PMID: 26509152 BACKGROUND

• Paltura C, Guvenc A, Develioglu ON, Yelken K, Kulekci M. Original Research: Aerosolized Lidocaine: Effective for Safer Arousal After Suspension Laryngoscopy. J Voice. 2020 Jan;34(1):130-133. doi: 10.1016/j.jvoice.2018.08.012. Epub 2018 Sep 15.

  PMID: 30227980 BACKGROUND

• Stout DM, Bishop MJ, Dwersteg JF, Cullen BF. Correlation of endotracheal tube size with sore throat and hoarseness following general anesthesia. Anesthesiology. 1987 Sep;67(3):419-21. doi: 10.1097/00000542-198709000-00025. No abstract available.

  PMID: 3307536 BACKGROUND

• Sahbaz M, Khorshid L. The Effect of Cold Vapor and Ice Cube Absorption in the Early Postoperative Period on Sore Throat and Hoarseness Induced by Intubation. J Perianesth Nurs. 2020 Oct;35(5):518-524. doi: 10.1016/j.jopan.2019.12.007. Epub 2020 May 10.

  PMID: 32402773 BACKGROUND

Related Links

• Paltura, C., \& Yüceant, G. A. (2018). Kısa süreli endotrakeal entübasyonun ses kalitesi ve aralığına etkisi. Çağdaş Tıp Dergisi, 8(1), 26-28.
• Zaman, F., \& Karahan, E. (2020). The Effect of Cold Vapor Treated to Thyroidectomy Patients During Early Postoperative Period. Eastern Journal of Medicine, 25(1), 118-125.
• Ghaleb, M. A., Falatah, S., \& Al-Amoudi, F. A. (2013). The efficacy of licorice gargle for attenuating postoperative sore throat. Am J Res Commun, 1(11), 379-94.
• AKKUŞ, İ. B., \& ÇAPARLAR, C. Ö. (2020). Başın Hiperekstansiyonu Endotrakeal Kaf Basıncını Etkiler mi?. Turkiye Klinikleri J Anest Reanim, 18(1), 1-7.

MeSH Terms

Conditions

Common Cold; Pharyngitis; Cough; Hoarseness; Deglutition Disorders

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Picornaviridae Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Pharyngeal Diseases; Stomatognathic Diseases; Otorhinolaryngologic Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Voice Disorders; Laryngeal Diseases; Neurologic Manifestations; Nervous System Diseases; Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases

Central Study Contacts

Özlem İbrahimoğlu, PhD

CONTACT

+905436195971; oogutlu@gmail.com

Hatice Erdoğan, PhD

CONTACT

+905536199454; haticeerdogan74@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assisstant Professor

Model Details: Patients who were hospitalized for surgical intervention in the supine and prone position and met the sample selection criteria will be included in the experimental and control groups by block randomization method using the random numbers table on the computer.

Study Record Dates

• First Submitted: March 8, 2022
• First Posted: April 7, 2022
• Study Start: April 18, 2022
• Primary Completion: October 1, 2022
• Study Completion: November 1, 2022
• Last Updated: April 7, 2022

Record last verified: 2022-04

Data Sharing

• IPD Sharing: Will not share