实用医学杂志2025，Vol.41Issue(5)：704-710,7.DOI:10.3969/j.issn.1006-5725.2025.05.013
使用降噪耳机隔离术中噪声对食管胃病变内镜下黏膜下剥离术后早期恢复质量的影响
Effects of noise isolation using noise-cancelling headphones during esophageal or gastric endoscopic submu-cosal dissection for postoperative recovery quality
摘要
Abstract
Objective To investigate the impact of noise isolation through the use of noise-cancelling headphones on the quality of postoperative recovery following esophageal or gastric endoscopic submucosal dissec-tion.Methods This is a prospective,parallel-group,randomized controlled clinical trial.Patients aged 18 years or older,regardless of gender and with ASA physical status Ⅰ-Ⅳ,who underwent elective esophageal or gastric endoscopic submucosal dissection under general anesthesia with endotracheal intubation from August 2023 to February 2024 were randomly assigned to either a control group or an observation group using a random number table.In the observation group,noise-cancelling headphones were used to reduce intraoperative noise intensity during general anesthesia,while the control group did not receive any noise isolation measures.The study recorded the average noise intensity during surgery and the proportion of intraoperative time with noise intensity≥70 dB.The primary outcome was the quality of recovery at 24 hours postoperatively,assessed using the 15-item Quality of Recovery Scale(QoR-15).Secondary outcomes included QoR-15 scores at 48 hours postoperatively,resting and movement-evoked pain scores measured by the Visual Analog Pain Scale(VAS)immediately after extubation,upon leaving the resuscitation room,and at 24 and 48 hours postoperatively,as well as analgesic drug consumption during surgery and within 48 hours postoperatively.Additionally,sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI)at 48 hours postoperatively.Results Compared with the control group,the observation group exhibited a significant increase in QoR-15 score at 24 hours post-surgery[(123.43±5.92)vs.(119.75±6.62),t=3.211,P=0.002].The resting VAS score[1(0,3)vs.2(2,3),Z=-3.755,P<0.001]and movement-evoked VAS score[2(1,3)vs.3(2,3),Z=-2.959,P=0.003]of the observation group immediately after extubation were significantly lower than those of control group.There was no significant difference in resting and movement-evoked VAS scores between the two groups when leaving the resuscitation room or at 24 and 48 hours after surgery(P>0.05).The intraoperative fentanyl consumption was significantly lower in the observation group compared to the control group[(0.23±0.05)vs.(0.27±0.06),t=3.515,P=0.01].There were no significant differences in remifentanil consumption during surgery or in the frequency of rescue analgesia with flurbiprofen axetil within 48 hours post-surgery(P>0.05).Postoperative PSQI scores were significantly lower in the observation group compared to the control group[(5.40±2.57)vs.(6.63±3.23),t=2.313,P=0.022].Conclusion The use of noise-cancelling headphones for intraoperative noise isolation is a safe and effective strategy that enhances postop-erative recovery quality,alleviates postoperative pain,and decreases the overall consumption of analgesic drugs in patients undergoing endoscopic submucosal dissection of esophageal and gastric lesions under general anesthesia.关键词
噪声/内镜下黏膜下剥离术/全身麻醉/术后恢复质量/术后疼痛Key words
noise/endoscopic submucosal dissection/general anesthesia/postoperative recovery quality/postoperative pian分类
医药卫生引用本文复制引用
宋芬,刘晓杰,刘玥..使用降噪耳机隔离术中噪声对食管胃病变内镜下黏膜下剥离术后早期恢复质量的影响[J].实用医学杂志,2025,41(5):704-710,7.基金项目
江苏省第六期"333高层次人才培养工程" （）
南京市卫生科技发展专项资金项目(编号:YKK21064) （编号:YKK21064）
