Pharmacological Interventions for Post-operative Sore Throat (POST): A Network Meta-analysis

Abstract

Background: To study the efficacy of current post-extubation pharmacologic treatments for postoperative sore throat (POST) prevention. Method: We searched nine databases for randomized controlled trials (RCTs) assessing the efficacy of post-extubation treatments in POST prevention. A network meta-analysis was used to pool the results. Results: Of the 124 records screened, we included 13 studies with 1820 patients. Ketorolac tromethamine was found to be the most effective with the lowest POST rates (P-score = 0.99), followed by ketamine (P-score = 0.68), amyl-m-cresol (P-score = 0.67), flurbiprofen (P-score = 0.66), benzydamine hydrochloride (P-score = 0.62), magnesium (P-score = 0.33), dexamethasone (P-score = 0.30), and lidocaine (P-score = 0.07). Moreover, the following treatments were found to be significantly effective in reducing POST in comparison to control/placebo treatment: ketorolac tromethamine (OR = 0.11; [95% CI=0.05 – 0.21]) followed by ketamine (OR = 0.32; [95% CI = 0.17 – 0.62]), amyl-m-cresol (OR = 0.32; [95% CI = 0.14 – 0.73]), flurbiprofen (OR = 0.33;[95% CI = 0.13 – 0.81]), and benzydamine hydrochloride (OR = 0.36; [95% CI = 0.24 –0.54]). Conclusion: Ketorolac tromethamine, ketamine, amyl-m-cresol, flurbiprofen, and benzydamine hydrochloride were found to be significantly effective in reducing POST. Moreover, ketorolac tromethamine was the most effective and significantly better than all other treatments in reducing POST rates.