The Effects of Budesonide Nebulization on Post-operative Sore Throat After General Anaesthesia

Abstract

Post-operative sore throat after general anaesthesia with endo-tracheal intubation occurs in 21% to 65% of patients.1 It has been reported to be one of the most undesirable outcomes in the post-operative period influencing patient satisfaction.2 Complaints range from minor throat irritation to debilitating pain, inability to swallow and temporary hoarseness of voice. Routine tracheal intubation for surgical procedures can result in pathological changes, trauma and nerve damage which may cause post operative sore throat. Several non-pharmacological methods like small sized endotracheal tubes,3 lubricating the endotracheal intubation tube with water soluble jelly, intubation after full relaxation, minimizing intra-cuff pressure and extubation when cuff is fully deflated, the pharmacological measures include gargling and nebulization with drugs like budesonide, beclomethasone, ketamine, lignocaine etc., have been studied.4,5 Budesonide is a non-halogenated glucocorticoid with powerful anti-inflammatory effects. It relieves congestion, reduces capillary permeability and oedema in the laryngeal mucosa. It is the only corticosteroid approved by FDA that can be used for aerosol inhalation.5 There are no studies on Indian population to evaluate the efficacy of budesonide on post-operative sore-throat. We found that Budesonide nebulization in a dose of 1 mg, 15 minutes before endotracheal intubation reduced the incidence and severity of sore-throat, cough and hoarseness of voice in the post-operative period up to 24 hrs in patients who underwent elective middle ear surgery under general anaesthesia. There were no systemic side effects with budesonide nebulization and patient satisfaction was good.