The Efficacy of Single-Dose Aescin in Preventing Postoperative Sore Throat Compared to Placebos: A Double-Blinded, Randomized Controlled Trial

Abstract

Background: Postoperative sore throat (POST) is a common complication found in surgical patients undergoing general anesthesia with endotracheal tube (ETT). Its severity varies and may affect postoperative outcomes and patient satisfaction. Aescin is an extract from horse chestnut (Aesculus Hippocastanum) that possesses the anti-inflammatory, venous decongestion, and antiedema property with few side effects. Objective: To demonstrate the reduction of incidence and severity of POST in patients undergoing general anesthesia with ETT. Materials and Methods: One hundred and seventeen patients, ASA I and II undergoing general anesthesia with ETT with elective surgery (abdominal, breast, gynecological, orthopedics) in a university hospital were enrolled and allocated randomly to aescin (A) or placebo (P) group. Patients, investigators, and research assistants were blinded to the allocation. Patients in A group (n=58) received aescin (Reparil®) 40 mg orally 2 to 6 hours prior to surgery and P group (n=59) received placebo. Anesthesia care was identical and under blinded staff anesthesiologist’s discretion. The presence/absence of POST, numerical pain score of POST, adverse events and cumulative analgesics consumption were recorded postoperatively at 30, 60 minutes, 2, 4, and 24 hours. Results: Thirty-seven and 34 patients in A and P group, respectively, developed POST which was not different significantly at all time points. Numerical pain score at all time points did not differ between groups statistically. However, log-rank test analysis revealed that A group had a slightly more rapid recovery from POST than P group (0.0013 vs. 0.0007 case/person-minute, p=0.03). Side effects and analgesics consumption did not differ between groups. Conclusion: Single 40 mg oral dose of aescin preoperatively, compare to placebo, did not reduce the incidence or severity of POST in the first 24 postoperative hours. Aescin, however, hastened the speed of recovery of POST compare to placebo with statistical significance. Keywords: Aescin; Incidence; Postoperative sore throat; Reparil