Nebulized dexmedetomidine for preventing postoperative sore throat after tracheal intubation: a randomized, double‐blind clinical trial

Abstract

Background and Objective: Endotracheal intubation is part of general anesthesia, and probably the most commonly performed airway related procedure in operating rooms as well as intensive care units. It may be a causative factor in about 74% of patients who experience postoperative sore throat (POST) due to airway mucosal injury. This double-blind randomized clinical trial assessed the effectiveness of nebulized dexmedetomidine in preventing POST by comparing with a control group.
 Methodology: In this randomized, double‐blind clinical trial, we enrolled 56 patients, who were to undergo general anesthesia with endotracheal intubation. Patients were randomly divided into two groups of 28 each. Group A received dexmedetomidine nebulization, and Group B had normal saline nebulization, both for 15 min before induction. POST was assessed at 1, 2, 4, 6, 12, and 24 h after extubation using a POST scale. Data were collected and statistically analyzed
 Results: The overall incidence of POST was 60.3%: Control group experienced POST by 28 (96.6%) patients, compared to 7 (24,1%) patients in dexmedetomidine group (P = 0.0001). Differences were significant at recording times post-operatively. The dexmedetomidine group had milder sore throats, less coughing, and lower heart rates/blood pressures compared to the control group.
 Conclusion: Patients who were nebulized with dexmedetomidine, experienced lower rates and intensity of postoperative sore throat compared to the control group. Administering dexmedetomidine via nebulization before intubation can be considered a safe and effective method for reducing postoperative sore throat, with less postintubation hemodynamic derangement.
 Abbreviations: ETT: Endotracheal Tube; GA: General Anesthesia; IL: Interleukin; MAC: Minimum Alveolar Concentration; N2O: Nitic Oxide; PACU: Post Anesthesia Care Unit; PONV- Postoperative Nausea and Vomiting; POST- Postoperative Sore Throat; TNF: Tumor Necrosis Factor
 Key words: Dexmedetomidine; Endotracheal Intubation; Anaesthesia, General; Nebulization; Postoperative sore throat
 Citation: Pradian E, Kestriani SS ND, Ritonga DZ. Nebulized dexmedetomidine for preventing postoperative sore throat after tracheal intubation: a randomized, double‐blind clinical trial. Anaesth. pain intensive care 2023;27(6):737−744. DOI: 10.35975/apic.v27i6.2348
 Received: Aug 28, 2023; Revised: Oct 21, 2023; Accepted: Oct 21, 2023