Incidence Of Postoperative Sore Throat Research Articles

A Study to Evaluate the Efficacy of Preoperative Low-dose Nebulised Dexamethasone in Decreasing the Incidence of Postoperative Sore Throat in Patients Undergoing Surgery Under General Anaesthesia

Background and Aims: Postoperative sore throat (POST) is a stereotypical postoperative complication that usually occurs in approximately 21%–65% of patients who are under general anaesthesia and is ranked around eighth among the most undesirable subjective and unpleasant complaints by the society of American anaesthesiologist after general anaesthesia. As airway management is a crucial factor in the causation of POST, various methods, especially non-pharmacological, are used to reduce the incidence of postoperative sore throat with the use of a small-sized endotracheal tube with low intracuff pressures. The tracheal tube is applied with other agents that may help in reducing the symptoms such as steroids, lozenges, lignocaine, ketamine gargles, inhalation of steroids (also included in pharmacological methods used for reducing the incidence of postoperative sore throat). Aim and Objective: The aim of this study was to evaluate the efficacy of prophylactic low-dose nebulised dexamethasone for decreasing the incidence of post-extubation sore throat and to evaluate the complications of low-dose dexamethasone nebulisation in patients undergoing surgery under general anaesthesia. Patients and Methods: The study was done in the Anaesthesiology Department of Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR) Mullana, Ambala, after institutional ethical committee approval and written, informed consent was obtained from the patients from March 2021 to March 2022 with a group size of Group S – 25 patients and Group D – 25 patients. Observation and Results: The results showed that patients in the dexamethasone group had a lower POST rate compared to the control group. Conclusion: We concluded that a low dose of 4 mg dexamethasone was effective in reducing the incidence and severity of POST in patients after anaesthesia, and no side effects compared to 4 mg normal saline.

Effects of preoperative inhaled budesonide combined with intravenous dexamethasone on postoperative sore throat in patients who underwent thyroidectomy: A randomized controlled trial.

This randomized controlled trial aimed to evaluate the efficacy of preoperative inhaled budesonide combined with intravenous dexamethasone on postoperative sore throat (POST) after general anesthesia in patients who underwent thyroidectomy. Patients who underwent elective thyroidectomy were randomly divided into the intravenous dexamethasone group (group A) and budesonide inhalation combined with intravenous dexamethasone group (group B). All patients underwent general anesthesia. The incidence and severity of POST, hoarseness, and cough at 1, 6, 12, and 24 hours after surgery were evaluated and compared between the 2 groups. There were 48 and 49 patients in groups A and B, respectively. The incidence of POST was significantly lower at 6, 12, and 24 hours in group B than that in group A (P < .05). In addition, group B had a significantly lower incidence of coughing at 24 hours (P = .047). Compared with group A, the severity of POST was significantly lower at 6 (P = .027), 12 (P = .004), and 24 (P = .005) hours at rest, and at 6 (P = .002), 12 (P = .038), and 24 (P = .015) hours during swallowing in group B. The incidence and severity of hoarseness were comparable at each time-point between the 2 groups (P > .05). Preoperative inhaled budesonide combined with intravenous dexamethasone reduced the incidence and severity of POST at 6, 12, and 24 hours after extubation compared with intravenous dexamethasone alone in patients who underwent thyroidectomy. Additionally, this combination decreased the incidence of postoperative coughing at 24 hours.

COMPARISON BETWEEN NEBULISATION OF MGSO4 20 MG/KGBW WITH KETAMINE 0.5 MG/KGBW ON THE INCIDENT OF POST-OPERATIVE SORE THROAT DUE TO ENDOTRACHEAL INTUBATION IN PATIENTS UNDERGOING GENERAL ANESTHESIA IN DR. HASAN SADIKIN HOSPITALS BANDUNG

Post Operative Sore Throat (POST) is a Symptoms often experienced by patients after surgery under general anesthesia and endotracheal intubation. The incidence of POST is between 21-71.8. POST causes discomfort to patients which can prolong hospital stay. In this study, a comparison was made between MgSO4 nebulization 20 mg/ KgBW and ketamine nebulization 0.5 mg/ KgBW on the incidence of POST after general anesthesia at RSUP Dr. Hasan Sadikin Bandung . This study used a double blind randomized controlled trial design. 72 elective surgery patients were randomly divided into 2 groups. Group M was given MgSO4 nebulization while group K was given ketamine nebulization. Nebulization was performed 15 minutes before induction of general anesthesia. POST monitoring was performed at 1, 4 and 24 hours after extubation using POST scoring. In this study, it was found that the incidence of POST in group M, namely the 1st hour of 13.5, the 4th hour of 10.8 and the 24th hour of 0 was lower than that in group K, namely the 1st hour of 28.5, the 4th hour of 32.5 and the 24th hour of 0. Statistical test results p0.033 showed a significant difference in group M better than group K at the 4th hour in reducing the incidence of POST. MgSO4 and ketamine have antinociceptive and anti-inflammatory effects with the mechanism of action of blocking NMDA receptors that inhibit calcium influx that avoids central sensitization. MgSO4 also has a muscle relaxing effect and reduces airway mucus secretion, thus reducing the risk of trauma during endotracheal intubation. The conclusion of this study is that MgSO4 nebulization shows a lower incidence of POST than ketamine nebulization.

Effect of continuous measurement and adjustment of endotracheal tube cuff pressure on postoperative sore throat in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial.

Postoperative sore throat (POST) is a common complication following endotracheal tube removal, and effective preventive strategies remain elusive. This trial aimed to determine whether actively regulating intraoperative cuff pressure below the tracheal capillary perfusion pressure threshold could effectively reduce POST incidence in patients undergoing gynecological laparoscopic procedures. This single-center, randomized controlled superiority trial allocated 60 patients scheduled for elective gynecological laparoscopic procedures into two groups: one designated for cuff pressure measurement and adjustment (CPMA) group, and a control group where only cuff pressure measurement was conducted without any subsequent adjustments. The primary outcome was POST incidence at rest within 24h post-extubation. Secondary outcomes included cough, hoarseness, postoperative nausea and vomiting (PONV) incidence, and post-extubation pain severity. The incidence of sore throat at rest within 24h after extubation in the CPMA group was lower than in the control group, meeting the criteria for statistically significant superiority based on a one-sided test (3.3% vs. 26.7%, P < 0.025). No statistically significant differences were observed in cough, hoarseness, or pain scores within 24h post-extubation between the two groups. However, the CPMA group had a higher incidence of PONV compared to the control group. Additionally, the control group reported higher sore throat severity scores within 24h post-extubation. Continuous monitoring and maintenance of tracheal tube cuff pressure at 18 mmHg were superior to merely monitoring without adjustment, effectively reducing the incidence of POST during quiet within 24h after tracheal tube removal in gynecological laparoscopic surgery patients. The study was registered at www.chictr.org.cn (ChiCTR2200064792) on 18/10/2022.

Role of preoperative zinc, magnesium and budesonide gargles in Postoperative Sore Throat (POST) - a randomised control trial.

Post-operative sore throat (POST) has an incidence ranging from 21 to 80%. To prevent the development of POST, several pharmacological measures have been tried. Aim of this study was to compare the efficacy of preoperative zinc, magnesium and budesonide gargles in reducing the incidence and severity of POST in patients who underwent endotracheal intubation for elective surgeries. We conducted a prospective, randomized, double-blind, controlled equivalence trial in 180 patients admitted for elective surgical procedures under general anaesthesia. Patients were randomised into three groups; group Z received 40mg Zinc, group M received 250mg Magnesium Sulphate and group B received 200µg Budesonide in the form of 30ml tasteless and colourless gargle solutions. Sore throat assessment and haemodynamic recording was done postoperatively at immediate recovery (0h) and 2, 4, 6, 8, 12 and 24h post-operatively. POST was graded on a four-point scale (0-3). POST score was comparable at all recorded time points i.e. 0,2,4,6,8,12 and 24h. Maximum incidence was seen at 8h in group B (33.3%) and the minimum incidence was at 24h in group Z (10%) (p > 0.05). It was found that the incidence of POST was more in the surgeries lasting longer than 2h in all groups. This difference was found to be statistically significant in Groups M and B. The incidence of POST was found to be comparable between laparoscopic and open procedures. Magnesium, zinc and budesonide have an equivocal effect in the prevention of POST at different time points. The incidence of sore throat increases significantly in surgeries lasting more than two hours if magnesium or budesonide have been used as premedicant. Duration of surgery is an independent predictor for POST. CTRI/2021/05/033741 Date-24/05/2021(Clinical Trial Registry of India).

The Effect of Topical Benzydamine Hydrochloride and Cuff Pressure Monitorization on Postoperative Sore Throat Due to Intubation.

Postoperative sore throat (POST) is the most common discomfort after endotracheal intubation. Damage to the tracheal mucosa caused by inappropriate endotracheal tube (ETT) cuff pressure has been shown as the major factor. Monitoring the ETT cuff pressure at a certain value reduces this damage. Benzydamine hydrochloride (BH) has proven to be effective on sore throat and studies have shown that it is also effective on POST. In this study, the efficacy of BH and ETT cuff pressure monitoring on POST was evaluated. After ethics committee approval 210 patients in the ASA (American Society of Anesthesiologists) I-III risk group undergoing elective surgery were included in the study. Routine anesthesia monitoring, induction, and maintenance were provided. Patients were randomly divided into three groups. Thirty minutes before surgery, the posterior pharyngeal wall was sprayed with BHin group 1and distilled water in groups 2 and 3. Intraoperatively, the first and second groups were monitored to keep the ETT cuff pressure between 22 and 26 cmH2O, while no intervention was performed in the third group. The incidence and severity of postoperative dysphagia, hoarseness, and POST were questioned. There was no difference between demographic data, and gender was not associated with POST. There was a statistically significant difference between the first and second groups and the third group in terms of all three symptoms questioned (p<0.01). No difference was observed between the first and second groups. Side effect rates were similar. Smoking was not found to be associated with symptoms. The incidence and severity of POST, dysphagia, and hoarseness are reduced when the ETT cuff is inflated with a pressure of 22-26 cmH2O after intubation with a manometer and maintained at this pressure range throughout the operation. There was no beneficial effect of BH.

Role of preoperative dexamethasone nebulization versus ketamine nebulization in reducing complications of nasogastric tube after laparoscopic surgery

Background &amp; objective: Nasogastric (NG) tube insertion is a frequently performed medical procedure. Most of the time, the oropharyngeal discomfort is usually underestimated, and insertions are carried out with just regular lubricant jelly and no additional painkillers, which results in less-than-ideal pain management. We compared the effectiveness of preemptive use of nebulized ketamine and dexamethasone in preventing post-operative sore throat following NG tube insertion in laparoscopic surgery.&#x0D; Methods: This prospective randomized double-blind controlled study was carried on 108 patients of both sexes with ASA physical status I-II. aged 20-60 years, undergoing laparoscopic abdominal surgeries under general anesthesia. Patients were randomized into 3 equal groups. Group D received a dose of 8 mg nebulized dexamethasone. Group K received 50 mg nebulized ketamine. Group S received 5 ml of nebulized saline. NG tube was passed after induction of general anesthesia. Postoperative sore throat was enquired from the patients at full recovery (zero hour), then at 2, 8, 12 and 24 h. Computer software (SPSS 15.0.1. for Windows; SPSS Inc, Chicago, IL, 2001) was used for data analysis. Non-parametric quantitative data, median, range, percentages, and numbers are given for qualitative data. The appropriate analysis was conducted in line with the data obtained. P &lt; 0.05 was regarded as significant.&#x0D; Results: The incidence of postoperative sore throat (POST) was lower with both nebulized dexamethasone and nebulized ketamine compared with nebulized saline; and significantly lower with dexamethasone compared with ketamine at 0 h (P &lt; 0.001), 2 h (P &lt; 0.001), 8 h (P &lt; 0.001), 12 h (P &lt; 0.001), and 24 h (P &lt; 0.001).&#x0D; Conclusion: The current study revealed that preoperative nebulized dexamethasone was more effective than nebulized ketamine in reducing postoperative sore throat.&#x0D; Abbreviations: NG- Nasogastric; NMDA- N-Methyl-D-Aspartate; PONV- Postoperative Nausea and Vomiting; POST- Postoperative Sore Throat; VAS- Visual Analogue Scale&#x0D; Key words: Nebulization; Dexamethasone; Ketamine; Laparoscopic Surgery; Nasogastric Tube&#x0D; Citation: Zakaria MM, Mohammed Aboulella SK, Hassanein SMK, Elsayed El Hennawy AM, Salah El Din Shabana TS. Role of preoperative dexamethasone nebulization versus ketamine nebulization in reducing complications of nasogastric tube after laparoscopic surgery. Anaesth. pain intensive care 2024;28(1):62-67.&#x0D; DOI: 10.35975/apic.v28i1.2275&#x0D; Received: 22 July, 2023; Reviewed: 04 October 2023; Accepted: 30 October 2023

Superior Laryngeal Nerve Block for Microlaryngoscopic Surgery: A Systematic Review and Meta-Analysis.

To assess the safety and efficacy of superior laryngeal nerve block (SLNB) for microlaryngoscopic surgery (MLS). PubMed, Embase, Web of Science, Ovid Medline, Cochrane Library, CNKI database, VIP database, Wanfang database, and trial registry databases. PICOS principles were performed: adults undergoing MLS receiving SLNB compared with no-SLNB in randomized controlled trials were included. Primary outcome included the incidence of severe postoperative sore throat (POST). Secondary outcomes included perioperative mean arterial pressure (MAP) and heart rate (HR), incidence of severe postoperative cough, and anesthesia recovery time. Eleven articles with 728 patients were included. Results indicated that SLNB provides lower incidence of severe POST in post-extubation 30 min (relative ratio [RR] = 0.13; 95% confidence intervals [CIs]: 0.05 ~ 0.34), 2 h (RR = 0.09; 95% CI: 0.02 ~ 0.36), 4-6 h (RR = 0.11; 95% CI: 0.03 ~ 0.41), and 24 h (RR = 0.15; 95% CI: 0.03 ~ 0.83); lower MAP (tracheal intubation: standardized mean difference [SMD] = -1.59; 95% CI: -1.69 to -0.42); suspension laryngoscope insertion: (SMD = -0.98; 95% CI: -1.49 to -0.46); tracheal extubation: (SMD = -0.78; 95% CI:-1.24 to -0.31); post-extubation 5 min: (SMD = -0.95; 95% CI: -1.41 to -0.49); lower HR (tracheal intubation: mean difference [MD] = -9.71; 95% CI: -17.16 to -2.27); suspension laryngoscope insertion: (MD = -8.64; 95% CI: -16.79 to -0.49); tracheal extubation: (MD = -10.13; 95% CI: -17.86 to -2.39); post-extubation 5 min: (MD = -13.44; 95% CI: -22.53 to -4.35); lower incidence of severe postoperative cough in post-extubation 30 min (RR = 0.18; 95% CI: 0.06 ~ 0.57) and 2 h (RR = 0.13; 95% CI: 0.02 ~ 0.69); and shorter anesthesia recovery time (MD = -5.34; 95% CI: -8.81 to -1.86) compared to controls. SLNB could provide lower incidence of severe POST, more stable perioperative MAP and HR, lower incidence of severe postoperative cough, and shorter anesthesia recovery time for MLS. I Laryngoscope, 2024.

Endotracheal Tube Cuff Pressures and Incidence of Postoperative Sore Throat

Abstract not available J Bangladesh Coll Phys Surg 2024; 42: 4-5

Evaluation of Preventive Effect of Zinc Lozenge on Sore Throat after Placement of ProSeal Laryngeal Mask Airway: A Randomised Controlled Study

Introduction: Postoperative Sore Throat (POST) is a known complication after general anaesthesia with an endotracheal tube (14.4% to 50%) and less so with Supraglottic Airway (SGA) devices (5.8% to 34%). Various modalities and drugs can decrease POST. Zinc possesses anti-inflammatory and antioxidant properties and is utilised in oral mucositis and xerostomia. Aim: To evaluate the effect of preoperative administration of a zinc lozenge on POST after the removal of the Proseal Laryngeal Mask Airway (PLMA). Materials and Methods: In this randomised, double-blinded controlled study was conducted at the Department of Anaesthesia at Pt. BD Sharma PGIMS, Rohtak, Haryana, India, over a period of five months from August 2020 to December 2020. 100 patients aged 18-60 years of either sex belonging to American Association of Anesthesiologists (ASA) I and II undergoing elective surgery under general anaesthesia with PLMA placement were randomly allocated into two groups to receive a 40 mg zinc lozenge (Group-I) or placebo (Group-II) and were asked to chew it 30 minutes preoperatively. Patients with upper respiratory tract infections, at risk of aspiration, or with anticipated difficult intubation were excluded from the study. The incidence and severity of POST were assessed on a 4-point scale (0-3) at 30 minutes, 2, 4, and 24 hours postoperatively. The primary outcome of the study was the incidence of POST at four hours postoperatively, and the secondary outcome was the severity of POST at 30 minutes, two hours, and 24 hours postoperatively. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software programme. The Chi-square test and unpaired t-test were used for statistical analysis. Results: The mean age in Group-I was 38.6±12.32 years and in Group-II was 37.90±14.84 years (p-value 0.79). Data regarding the distribution of patients according to sex were comparable with a p-value of 0.31. There was a significantly lower incidence of POST in Group-I (zinc group) than in Group-II (placebo group) at four hours with a p-value of 0.004. Conclusion: The present study has shown that the preoperative administration of a 40 mg zinc lozenge effectively reduces the incidence and severity of POST in the postoperative period, peaking at four hours after general anaesthesia. Zinc lozenges are easy, convenient, non invasive, and successfully prevent POST.

Postoperative Sore Throat among Patients Following General Anesthesia with Endotracheal Intubation in a Tertiary Care Centre.

Postoperative sore throat is the second most common minor adverse event after general anaesthesia with endotracheal intubation. It is an uncomfortable and stressful sequel of tracheal intubation. The incidence of postoperative sore throat varies across different studies and type of anesthesia technique used. The aim of the study was to find out the prevalence of postoperative sore throat following general anaesthesia with endotracheal intubation in a tertiary care centre. A descriptive cross-sectional study was conducted among the patients who underwent surgery under general anaesthesia with endotracheal intubation from 1 December 2022 to 31 October 2023 after receiving ethical approval from the Institutional Review Committee. The anaesthesia technique was standardized in all the patients. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 200 patients, postoperative sore throat was seen in 86 (43%) (36.14-49.86, 95% Confidence Interval) patients. The maximum reported time of sore throat was at a fourth postoperative hour 80 (93.02%). The prevalence of postoperative sore throat among patients undergoing surgery under general anaesthesia with endotracheal intubation was similar to the studies conducted in similar settings. endotracheal intubation; general anaesthesia; prevalence.

Effect of thermal softening of double-lumen endobronchial tubes on postoperative sore throat in patients with prior SARS-CoV-2 infection: a randomized controlled trial

BackgroundThe incidence of postoperative sore throat (POST) after tracheal intubation using double-lumen endobronchial tubes (DLTs) is higher in patients with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than in the general population. This prospective trial was conducted to determine whether thermal softening of DLTs could decrease the incidence of POST or other airway injuries in patients with prior SARS-CoV-2 infection.MethodsA total of 120 patients with prior SARS-CoV-2 infection undergoing thoracoscopic surgery were randomly assigned to two groups (n = 60 each). In the thermal softening group, the distal portion of the DLT was placed in thermostatic saline (50 °C) for 10 min before endotracheal intubation. In the control group, the distal portion of the DLT was placed in room temperature saline for 10 min before endotracheal intubation. The incidence and severity of POST and hoarseness were assessed at 1, 6 and 24 h postoperatively. The primary outcomes were the incidence and severity of POST at 6 h postoperatively. The secondary outcomes were the incidence and severity of hoarseness, vocal cord and tracheal injuries, and hemodynamic changes in patients at intubation.ResultsThe incidence of POST at 6 h postoperatively was greater in the control group than in the thermal softening group [41 (68%) vs. 22 (37%), P = 0.001]. The overall incidence of POST at 24 h postoperatively was greater in the control group than in the thermal softening group [46 (76%) vs. 24 (40%), P < 0.001]. The overall incidence of tracheal injuries was also greater in the control group than in the thermal softening group (P = 0.016). Vocal cord injuries occurred more frequently in the control group than in the thermal softening group (P = 0.006).ConclusionThermal softening of DLTs before intubation can reduce the incidence of POST and airway injuries in patients with prior SARS-CoV-2 infection undergoing DLT insertion.Trial registrationThis trial has been registered at www.chictr.org.cn (registration number: ChiCTR2200066821; registration date: December 19, 2022).

Postoperative sore throat: prophylaxis and treatment

Postoperative sore throat (POST) is one of the most reported complications after general anesthesia with an incidence of as high as 60% which may impact patient satisfaction and increase the cost of treatment. The aim of this review is to summarize the currently accepted approaches and new trends intended to reduce the risk and increase the treatment efficacy of POST. Difficult intubation, traumatic intubation, and several other factors contribute to the development of POST. Endotracheal intubation using a stylet-loaded tube exerts excessive pressure on the anterior tracheal wall predisposing to mucosal trauma and contributing to development of POST. Pharmacological interventions are aimed at prevention, amelioration of symptoms, and treatment of POST. Medications suggested for this purpose include corticosteroids, topical sprays and creams, non-steroidal anti-inflammatory drugs (NSAID), and N-methyl-D-aspartate (NMDA) receptor antagonists. The use of video-laryngoscopes (VL) for endotracheal intubation improves the glottic view and increases the success rates with less force required to ensure adequate laryngoscopic view. Nevertheless, despite advances in laryngoscopic devices, the incidence of POST remains high. A novel intubation technique with endotracheal tube (ETT) rotation 180 degrees (ETT 180°) has been suggested to overcome stylet related injury and, possibly, decrease the POST. To date, no clinical trials have been conducted to test the efficacy of ETT 180° in reducing the incidence of POST. Undoubtedly, the suggested method deserves further investigation to determine its role in patient care.

A randomised, double-blind, comparative study of preoperative magnesium sulphate versus zinc sulphate gargle for prevention of postoperative sore throat following endotracheal intubation.

Magnesium sulphate and zinc sulphate have been reported to attenuate postoperative sore throat (POST). The study aims to compare the effect of preoperative magnesium sulphate and zinc sulphate gargle on the incidence and severity of POST following endotracheal intubation within 24 h. After ethics committee approval, 132 patients were randomly allocated to three groups (M, Z and D). Fifteen minutes before laryngoscopy and tracheal intubation, patients assigned to groups M and Z received a solution for gargle containing magnesium sulphate 20 mg/kg and zinc sulphate containing 40 mg of elemental zinc dissolved in 20 ml of 5% dextrose solution, respectively. Group D received 20 ml of 5% dextrose solution. Incidence and severity of POST (4-point score: Grade 0- no sore throat, Grade 1- mild sore throat, Grade 2- moderate sore throat, Grade 3- severe sore throat) was assessed for 24 h after extubation. Statistica, Version 8.0 (StatSoft, Inc., Tulsa, Oklahoma, USA) was used for analysing the data. The lowest incidence of POST in group M was 13.6% (95% confidence interval [CI] 3.5-23.7) compared to 0% in group Z, whereas the highest incidence recorded in group M was 25% (95% CI 12.2-37.7) in contrast to 13.6% (95% CI 3.5-23.7) in group Z during the first 24 h after operation. It was observed that the incidence of mild POST (POST score 1) was significantly lower (P < 0.05) in group Z compared to group M in the first 4 h postoperatively. Zinc sulphate gargle before laryngoscopy and tracheal intubation is more effective for reducing the incidence of POST than magnesium sulphate gargle.

Effect of Oral Care Solution on Sore Throat After I-Gel Laryngeal Mask General Anesthesia: A Randomized Controlled Trial.

Sore throat is a common complication after general anesthesia. Oral care solutions have been used to reduce the incidence of oral complications or ventilator-associated pneumonia, but their effect on postoperative sore throat (POST) is unclear. This study aims to investigate whether oral care solution can alleviate POST in patients undergoing i-gel laryngeal mask general anesthesia. A total of 120 patients who were scheduled for elective surgery under laryngeal mask general anesthesia were enrolled. The patients were randomly assigned to an experimental group (oral care solution) and a control group (0.9% saline) and gargled for 1 min with 10mL of oral care solution or saline 5 min before anesthesia induction. The primary outcomes were the overall incidence of sore throat within 24 h and incidence at 20 min, 1 h, 6 h, 24 h after removal of i-gel. The secondary outcomes were the severity of sore throat at the four time points and incidence of hoarseness, cough within 24 h after removal of i-gel. A total of 111 patients were included in the analysis. The overall incidence of sore throat within 24 h in the experimental group was significantly lower than that in the control group, as was the incidence at four time points (P<0.05). The VAS scores at the four time points in the experimental group were significantly lower than those in the control group (P<0.05), and the results of repeated measurement analysis of variance showed that time effect and intergroup effect were statistically significant (P<0.001). No differences were found between the groups in the incidence of hoarseness and cough. Gargling with oral care solution before anesthesia induction can significantly reduce the incidence and severity of POST in patients undergoing i-gel laryngeal mask general anesthesia.

Effects of ultrasound-guided stellate ganglion block on postoperative sore throat and postoperative sleep disturbance after lumbar spine surgery: a randomized controlled trial

BackgroundPostoperative sore throat and sleep disturbance are prevalent among patients undergoing spinal surgery, and these conditions can substantially impact their postoperative satisfaction and quality of life. The present study aimed to examine the impact of ultrasound-guided stellate ganglion block (SGB) on the occurrence of postoperative sore throat (POST) and postoperative sleep disturbance (PSD) in patients who undergo lumbar spine surgery under general anesthesia.MethodsSixty patients were randomly assigned to either the experimental group (SGB group) or the control group (CG). Both groups received the same induction and maintenance drugs. However, the SGB group received a right SGB under ultrasound guidance 15 min before anesthesia induction, while the CG did not receive any block anesthesia intervention before anesthesia induction. We monitored the incidence and severity of POST at 1, 6, 24, and 48 h after surgery in both groups. Additionally, we evaluated the deep sleep quality score on the first, second, and fifth days after surgery in both groups.ResultsThe incidence of POST at 1 h and 6 h after surgery was significantly lower in the SGB group (10.0% and 13.3%) than in the CG (43.3% and 36.7%) (P < 0.05). The postoperative sore throat scores of the SGB group (0.10 ± 0.31 and 0.17 ± 0.46) at 1 h and 6 h after surgery were lower than those of the CG (0.57 ± 0.73 and 0.50 ± 0.77) (P < 0.05). Moreover, the deep sleep quality score on the first, second, and fifth days after surgery were significantly higher in the CG (5.40 ± 3.37, 4.70 ± 3.19, 4.53 ± 3.44) than in the SGB group (3.87 ± 2.30, 3.13 ± 1.77, 3.03 ± 1.84) (P < 0.05).ConclusionUltrasound-guided SGB can reduce the incidence and severity of POST and improve PSD in patients undergoing lumbar spine surgery.Trial registrationThis study was registered on Chinese Clinical Trial Registry, (ChiCTR2200065279) on 01/11/2022.

Effects of Endotracheal Tube with Adhesive Superficial Laryngeal Electrodes for Intraoperative Nerve Monitoring on Laryngopharyngeal Complications during Thyroidectomy.

The endotracheal tube (ETT) with laryngeal adhesive electrodes for intraoperative neural monitoring (IONM) may be related to laryngopharyngeal complications, such as postoperative sore throat (POST), hoarseness, and coughing. We aimed to evaluate the effects of the ETT with laryngeal adhesive electrodes for IONM on the occurrence of laryngopharyngeal complications during thyroidectomy. In this retrospective study, we included 176 patients who underwent thyroidectomy for thyroid cancer between September 2020 and February 2021. The patients were categorized into control (n = 108) and IONM (n = 68) groups. Patients in the IONM group were intubated with the ETT with surface electrodes. Characteristics of the patients and surgery, perioperative variables, and laryngopharyngeal complications, including POST, hoarseness, and cough, were evaluated. The severity and incidence of POST were comparable between the two groups on postoperative days 0, 1, and 2 (p = 0.103, 0.386, and 0.056, respectively). Furthermore, no significant differences were observed in the occurrence of postoperative hoarseness and cough between the groups. The ETT with laryngeal adhesive electrodes for IONM during thyroidectomy did not affect the incidence and severity of postoperative laryngopharyngeal complications, including POST, hoarseness, and cough. Further prospective, double-blinded, randomized clinical trials are required to gain a clearer understanding.

A randomized comparative study to estimate the safety and effectiveness between laryngeal mask airway supreme and I-gel in patients undergoing elective surgeries

Background: Supreme laryngeal mask airway (SLMA) and i-gel airway devices are second generation supraglottic airway devices (SAD) and are good alternatives to intubation during elective surgeries. Aims and Objectives: This study was conducted with the objective of comparing the two SAD with respect to ease of insertion, number of attempts of insertion, insertion time, ease of gastric tube insertion, accompanying hemodynamic changes, incidence of adverse effects like regurgitation, lip and dental trauma, post-operative sore throat, dysphagia, and hoarseness. Materials and Methods: This study was conducted at M.G.M. Medical College and M.Y. hospital, Indore. Eighty patients belonging to ASA class 1 or 2, with Mallampati grading 1 or 2, between age group of 18–60 years and with BMI &lt;30 kg/m2 were selected for the study. After induction of anesthesia, one of the SAD’s (SLMA or i-gel) was inserted following randomization, and accordingly, the patients were divided into two groups of 40 each. Insertion parameters, hemodynamic, and respiratory parameters were noted. Patients were also observed for any possible complication at 1 h and 24 h postoperatively. Results: The Two groups showed no statistically significant difference in terms of demographic characteristics, insertion parameters, hemodynamic, or respiratory parameters (P&gt;0.05). Postoperatively, no significant complications were observed in terms of dental injury, laryngospasm. Ease of gastric tube insertion was found to be more in SLMA group than i-gel and the difference was statistically significant (P=0.0057). Incidence of sore throat after 1 h was found to be more in SLMA group than i-gel group (P=0.048). Conclusion: There was no significant difference between SLMA and i-gel in terms of insertion characteristics and hemodynamic changes. Ease of gastric tube insertion was found to be significantly more in SLMA group than i-gel. Incidence of post-operative sore throat at 1 h was more with SLMA as compared to i-gel.

A Neural Integrity Monitor Electromyography Endotracheal Tube Causes More Severe Postoperative Sore Throat Than a Standard Endotracheal Tube in Adults: A Prospective Cohort Study.

This study aimed at figuring out the different effects of a neural integrity monitor electromyography endotracheal tube (NIM-EMG-ETT) and a standard endotracheal tube (ETT) on postoperative sore throat (POST). This prospective cohort study enrolled 143 patients scheduled to undergo general anesthesia with endotracheal intubation. Patients were allocated into three groups: Group A, non-thyroid surgery with a standard ETT; Group B, thyroid surgery with a standard ETT; Group C, thyroid surgery with a NIM-EMG-ETT. The incidence, the severity and visual analog scale (VAS) of POST were recorded. The incidence and the severity of POST were tested by χ2 test or Fisher's exact test. And VAS of POST was tested by Kruskal-Wallis test. The incidences of POST in Group B and Group C were significantly higher than that of Group A at all the time points after extubation (P < 0.001). The incidences of POST in Group C was significantly higher than that in Group B at 8h, 24h and 48h after extubation (89.4% vs. 68.8%, P = 0.014, relative risk (RR) 1.30, 95% confidence interval (CI) 1.05-1.61; 89.4% vs. 58.3%, P = 0.001, RR 1.53, 95% CI 1.18-1.98; 76.6% vs. 45.8%, P = 0.002, RR 1.67, 95% CI 1.18-2.36). Moreover, there was a significant higher VAS of POST and more serious POST with Group C than with Group B. A NIM-EMG-ETT may induce higher incidence of POST and more serious POST than a standard ETT. Chinese Clinical Trail Registry ( http://www.chictr.org.cn/index.aspx , ChiCTR2200058896, 2022-4-18).

Alkalized lidocaine in a tapered cuff suppresses endotracheal tube-induced hemodynamic changes: a randomized controlled trial.

The use of an endotracheal tube (ET) cuff filled with alkalized lidocaine (AL) can suppress ET-induced emergence phenomena, such as hypertension, tachycardia and coughing, and postoperative sore throat (POST) and hoarseness (PH). The efficacy of intracuff lidocaine may vary depending on the cuff shape, but there has been no study on the effects of a tapered cuff filled with AL. We examined whether intracuff AL suppresses ET-induced emergence phenomena, POST and PH. Sixty-two patients were enrolled in this study and the patients were randomly allocated to a group in which the tapered cuff was filled with AL (Group AL) and a group in which the tapered cuff was filled with normal saline (Group S). The primary outcomes of this study were changes in mean blood pressure (MBP) and heart rate (HR) at extubation. MBP, HR and the number of coughs were recorded before and up to 10min after extubation. The degree of POST and the incidences of POST and PH were recorded at 15min, 2h and 24h after extubation. Changes in MBP before extubation and HR before and after extubation were significantly lower in Group AL than in Group S (p < 0.025). The number of coughs at extubation and the incidence of PH at 2h after extubation were significantly lower in Group AL than in Group S (p < 0.0001 and p = 0.014, respectively). AL in a tapered cuff significantly suppresses ET-induced cardiovascular changes in MBP and HR.