Incidence Of Postoperative Sore Throat Research Articles

Effect of Dental Throat Pack Used Under General Anesthesia in Children with Special Healthcare Needs on Postoperative Nausea, Vomiting, and Sore Throat: A Randomized Clinical Trial

Background/Objective: Throat packs are widely used during orofacial surgery to reduce the frequency of postoperative nausea and vomiting (PONV). However, evidence supporting their use is mixed, with associated risks such as postoperative sore throat and the possibility of being forgotten in situ. Methods: The aim of this study is to evaluate the effectiveness of throat packs in preventing PONV and postoperative sore throat during dental treatments under general anesthesia in children with special healthcare needs (SHCNs). Eighty children with SHCNs were randomized into two groups: throat packing (Group TP, n = 41) and no throat packing (Group n-TP, n = 39). A throat pack was used in Group TP, and PONV and sore throat were evaluated at 1, 2, and 4 h postoperatively. Statistical Package for Social Sciences (SPSS) version 23.0 was used for data analysis. The registration number at ClinicalTrials.gov is NCT06169306, registered on 28 December 2023. Results: Patients in Group n-TP showed significantly higher PONV values at 1 and 2 h postoperatively (p < 0.001, p = 0.019, respectively). Visual Analog Scale (VAS) values were also significantly higher in Group TP at 1 and 2 h postoperatively (p < 0.001, p = 0.002, respectively). Conclusions: Using throat packs in dental treatments under general anesthesia for children with SHCNs reduced the incidence of PONV but increased the incidence of postoperative sore throat.

The effect of preoperative topical magnesium sulfate spraying in the oropharyngeal region on postoperative sore throat following gynecological laparoscopic surgery: a randomized clinical trial

BackgroundPostoperative sore throat is a common complication following general anesthesia. This study aimed to investigate the impact of preoperative topical magnesium sulfate spraying in the oropharyngeal region on postoperative sore throat following gynecological laparoscopic surgery.MethodsThe study included 58 patients scheduled for gynecologic laparoscopic surgery at Xuzhou Medical University Affiliated Hospital. Patients were randomly assigned to either the magnesium sulfate group or the control group, with 29 patients in each group. In the magnesium sulfate group, 25% magnesium sulfate was sprayed at a dose of 15 mg/kg on the mucous membrane of the pharynx and posterior wall of the larynx near the glottis using a laryngoscope under visual guidance during intubation; in the control group, an equal volume of normal saline was used instead. The primary outcome measure was the overall incidence of postoperative sore throat 48 h after surgery.ResultsThe overall incidence of postoperative sore throat in the magnesium sulfate group was lower than that in the the control group (20.0% vs. 66.7%, P < 0.001). At time points T1 (P < 0.001), T2 (P = 0.02), and T3 (P = 0.015), the incidence of postoperative sore throat in the the magnesium sulfate group was also lower than that in the the control group.ConclusionThis study confirmed that preoperatively spraying magnesium sulfate locally in the Oropharyngeal Region can reduce the frequency and severity of postoperative sore throat.Trial registrationThe study was registered at Chictr.org.cn with the number ChiCTR2400087240 on 07/23/2024.

Effect of Nebulisation with Dexmedetomidine versus Magnesium Sulphate on Haemodynamic Response to Laryngoscopy and Intubation and Incidence of Postoperative Sore Throat: A Randomised Clinical Trial

Introduction: Laryngoscopy and endotracheal intubation are essential procedures in general anaesthesia but can induce sympathetic hyperactivity, leading to transient increase in blood pressure and Heart Rate (HR). This can be particularly risky for patients with co-morbidities. Various agents, including dexmedetomidine and magnesium sulphate, have been studied for their potential to mitigate these responses. Aim: To compare the effects of preoperative nebulisation with dexmedetomidine versus magnesium sulphate on haemodynamic responses during laryngoscopy and intubation and to determine the incidence of Postoperative Sore Throat (POST) in both groups. Materials and Methods: This randomised clinical, double-blind trial was conducted at Dr. D.Y. Patil Medical College, Pune, Maharashtra, India over the period of two years. It involved 80 patients undergoing surgery under general anaesthesia, divided into two equal groups. Group A received nebulisation with dexmedetomidine (1 µg/kg) and Group B received magnesium sulphate (240 mg) diluted in 0.9% normal saline to make a 3 mL solution. Institutional ethical approval and Clinical Trials Registry India (CTRI) registration were obtained. Haemodynamic parameters including HR, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and POST were monitored. Statistical Package for the Social Sciences (SPSS) version 20.0 was used for statistical analysis. Data were analysed using unpaired t-tests for quantitative data and Pearson’s Chi-square test for qualitative data, with significance set at p-value&lt;0.05. Results: Before nebulisation, group A had significantly higher HR and SBP than group B (p-value=0.003 and 0.009, respectively). Postnebulisation, there were no significant differences in HR or SBP between groups. However, group A had lower DBP and MAP during and after intubation and skin incision (p-value &lt;0.001, 0.001, and &lt;0.001 respectively for DBP and 0.030, 0.031 and 0.002 for MAP). Group A had a lower, though not statistically significant (p-value=0.36) incidence of POST compared to group B. Conclusion: Nebulisation with dexmedetomidine and magnesium sulphate both provided effective management of haemodynamic responses during intubation. Both agents decreased the incidence of POST.

Estudio sobre la eficacia de un gel que contiene betametasona al 0,05 %, lidocaína al 2 % y tetracaína al 1 % para reducir el dolor de garganta, la ronquera, la tos y la tos en el tubo durante la salida de la anestesia.

Postoperative sore throat is a common complaint and an undesirable outcome. It is often a side effect of general anesthesia, reported by 30% to 70% of patients following tracheal intubation. Despite advancements in laryngoscopy equipment, postoperative sore throat remains a common issue, requiring additional pharmacological interventions and negatively affecting patient satisfaction. This highlights the continued need for effective strategies to tackle this challenge in clinical practice. This study is a retrospective cohort analysis involving 101 patients who underwent elective plastic surgery with orotracheal intubation under general anesthesia. The research compares the incidence of postoperative sore throat, hoarseness, and cough, as well as coughing upon emergence from anesthesia, between two types of lubricated endotracheal tubes: one coated with a gel containing 0.05% betamethasone, 2% lidocaine, and 1% tetracaine, and another with 2% lidocaine jelly. At the 8-hour mark after extubation, the incidence of postoperative sore throat was significantly lower in the experimental group at 17.6%, compared to 58% in the 2% lidocaine jelly group (P&lt;0.001). Over the 24-hour evaluation, the experimental group consistently showed a lower incidence of postoperative sore throat at all measured time points. The 2% lidocaine group had an OR 2.0 CI 95% (1.48-2.93), 2.28 CI 95% (1.54-3.3), and 2.4 CI 95% (1.64-3.5) for postoperative sore throat at post-anesthesia care unit, 8 hours and 24 hours after surgery evaluation respectively. Our research highlights the potential benefits of applying a gel that contains corticosteroids and local anesthetics to the tracheal tube. This application may help reduce postoperative complications associated with tracheal intubation, including sore throat, coughing, irritation from the tube, and hoarseness.

Does the combination of intravenous lidocaine and dexamethasone reduce the incidence of postoperative sore throat? A randomized controlled trial

Does the combination of intravenous lidocaine and dexamethasone reduce the incidence of postoperative sore throat? A randomized controlled trial

Oral Endotracheal Intubation with Restricted Glottis View using C-MAC D Blade®: A Randomised Controlled Trial

Introduction: The perspective of airway management has undergone a considerable transformation since the advent of Video Laryngoscopes (VL). VL has rapidly been accepted as an intubation tool in a variety of clinical scenarios. This heralds a wide array of VL models with their own strengths and weaknesses. The C-MAC D blade® is one such VL with an angulated blade that provides an excellent glottis view, but negotiating the Endotracheal Tube (ETT) past the glottis opening and into the trachea might be difficult. No study till date was done on the C-MAC D blade® with different glottis views for intubation. Aim: To compare the Total Time of Intubation (TTI) with restricted glottis view and full glottis view with C-MAC D blade® as the primary aim, along with the first attempt intubation rate and complications during intubation. Materials and Methods: The present prospective single-centre randomised controlled trial was conducted in the Department of Anaesthesiology, Shree Krishna Hospital, PSMC, Karamsad, Gujarat, India, from September 2021 to August 2022. A total of 42 patients were randomly divided into two groups: group-F (n=21), which had a full glottis view, and group-R (n=21), which had a restricted glottis view. Randomised glottis views were achieved with the C-MAC D blade® VL during oral endotracheal intubation in both groups. Video recordings of the intubations were made, and TTI, first attempt success rate and complications during intubation were noted. Statistical analysis was done with an independent sample t-test to compare the two groups of continuous variables using STATA version 14.2. Results: The mean age in group-F was 45.86±10.83 years and in group-R was 47.76±9.14 years. The male-to-female ratio in group-F was 10:11 and in group-R was 9:12. Overall, the firstattempt successful intubation rate with the C-MAC D blade® in both groups was 90.48%. However, it was higher in group-R (95.24%) compared to group-F (85.71%). TTI was less in group-R compared to group-F (36.19±11.11 vs 45±15.89 seconds, p-value=0.0438). Group-R had lower incidence of postoperative sore throat (14.29% vs 57.14%, p-value=0.004) compared to group-F. Conclusion: Total time of intubation was less with a restricted glottis view compared to a full glottis view with C-MAC D blade® VL. Additionally, the restricted view had a higher first attempt intubation rate. Postoperative sore throat was significantly lower in the restricted view, with a lesser incidence of oropharyngeal trauma compared to the full glottis view.

Does intubation while observing the glottis with a fiberoptic scope reduce postoperative sore throat?

IntroductionIn oral maxillofacial surgery, the nasal tracheal tube is mostly used to provide a better surgical field for oral, head and neck operations. Postoperative sore throat and hoarseness are common following tracheal intubation, with an incidence of 11–55%. Then, we previously reported advantage technique of fiberoptic scope to decrease the risk which the tip of the tube is visualized as the tube is advanced which helps avoid impingement of the tube. However, the extent to which this technique causes postoperative complications is unknown compared to traditional technique. The aim of this study was retrospectively to determine the effect of postoperative sore throat following nasotracheal intubation by tip of the tube is visualized by fiberoptic scope.MethodAnesthesia records of the adult patients with nasotracheal intubation were checked. Patients underwent oral maxillofacial surgery from January 2021 until March 2023. Facilitated with rocuronium, nasotracheal intubation was performed using the traditional or observative method by fiberoptic scope with a 4.8 mm outer diameter. Intubation was performed with a cuffed 6.5–8.0 mm ID nasotracheal tube. The following variables were recorded: gender, age, height, weight, ASA classification, anesthesia time, duration of intubation, tube size, intubation attempts, fentanyl and remifentanil. The postoperative sore throat and the incidence of hoarseness were recorded at operative day and at the day after operative day, and the time to recovery.ResultA total of 104 cases (traditional fiberoptic intubation n = 51, observative fiberoptic intubation n = 53) were enrolled in this retrospective study. There were no significant differences in clinical characteristics and anesthetic data. There was not significant difference in incidence of postoperative sore throat, hoarseness and recovery between the two groups (P = 0.61, 0.44, 0.90). For subjects reporting postoperative sore throat (n = 30), there was not a significant difference in VAS means at operative day and at the day after operative day between the two groups (P = 0.81, 0.91).ConclusionWe found that postoperative sore throat and recovery were not influenced by observative fiberoptic scope for nasotracheal intubation.

Effects of GlideScope, Pentax Airway Scope, and Macintosh Blade on the incidence of postoperative sore throat: a cohort study of 9,881 patients

BackgroundPostoperative sore throat (POST) is a common complaint after general anesthesia. POST is defined by the presence of a self-reported foreign body sensation or a painful sensation in the throat after general anesthesia. This condition may affect recovery and patient satisfaction and is associated with many factors, including intubation tools. Previous studies have reported conflicting results on POST. This retrospective cohort study, with sample size of 9,881 patients, was conducted to confirm the hypothesis that the use of video laryngoscopy (VL) is associated with a lower incidence of POST compared with direct laryngoscopy (DL).MethodsData were extracted from a prospectively maintained quality improvement database. A total of 9,881 patients were included in the study. Statistical analysis was conducted for comparisons of demographic characteristics and to determine the effect of intubation tools on the incidence of POST.ResultsThe patients had similar baseline demographic characteristics. Compared with DL, VL was associated with a lower incidence of POST (12.98% vs. 17.49%, P < 0.001). In addition, the use of Pentax Airway Scope (AWS) was associated with a lower incidence of POST compared with the use of GlideScope (GVL, 8.14% vs. 16.25%, P < 0.001). To better adjust for possible confounding factors, mixed-effects generalized linear model analysis revealed that older age (odds ratio [OR]: 0.995, 95% confidence interval [CI]: 0.992–0.999, P = 0.006), AWS compared to DL (OR: 0.416, 95% CI: 0.350–0.494, P < 0.001), and male sex (OR: 0.836, 95% CI: 0.747–0.935, P = 0.002) are associated with reduced incidence of POST.ConclusionCompared with DL, VL is associated with a lower incidence of POST. In addition, the use of AWS is associated with a lower incidence of POST compared with the use of GVL.Trial registrationRetrospectively registered, NCT06515808, date of registration: 23/07/2024.

Effect of Lidocaine on Ciprofol Dosage and Efficacy in Patients Who Underwent Gastroscopy Sedation.

BACKGROUND Intravenous ciprofol is a short-acting sedative with minimal respiratory and circulatory suppression and limited analgesia. Intravenous lidocaine provides analgesia during surgical procedures. This study included 70 patients who underwent gastroscopy with analgesia and aimed to evaluate the effects of intravenous lidocaine on the dose of ciprofol required to produce 50% of the maximal effect (ED50). MATERIAL AND METHODS Seventy patients scheduled for elective painless gastroscopy were randomly assigned into 2 groups: group L (n=35, received ciprofol and 1.5 mg/kg lidocaine) and group S (n=35, received ciprofol and normal saline). The primary outcomes measured were the ED50 and the 95% effective dose (ED95) of ciprofol, determined using the modified up-down sequential method and Probit analysis. Secondary outcomes included induction, operation, and recovery times; monitoring of vital signs such as mean arterial pressure, heart rate, and oxygen saturation; and evaluation of postoperative adverse reactions, including sore throat, nausea, vomiting, abdominal pain, and satisfaction scores from endoscopists and anesthesiologists. RESULTS The ED50 of ciprofol in group L was 0.315 mg/kg (95% CI, 0.291-0.342 mg/kg), which was significantly lower than that in group S, 0.42 mg/kg (95% CI, 0.371-0.491 mg/kg). Additionally, group L exhibited shorter induction and recovery times, a lower incidence of postoperative sore throat, and a temporary drop in blood pressure following induction. CONCLUSIONS Intravenous lidocaine during painless gastroscopy reduces the required ciprofol dose, shortens induction and recovery times, and lowers the incidence of postoperative complications, such as sore throat. These findings support its effective role in improving sedation quality and patient outcomes during gastroscopy.

A visual laryngoscope combined with a fiberoptic bronchoscope improves intubation outcomes in patients with predicted difficult airways in thoracic surgery

ObjectiveTo study the clinical effectiveness of visual laryngoscopy combined with fiberoptic bronchoscopy-guided double-lumen endotracheal tube intubation in thoracic surgery patients with predicted difficult airways in thoracic surgery airways.MethodsWe randomly divided 162 patients with predicted difficult airways who required double-lumen tracheal intubation for thoracic surgery and randomly divided them into the video laryngoscopy group (Group VL, n = 54),fiberoptic bronchoscopy group (Group F, n = 54), and video laryngoscopy combined with fiberoptic bronchoscopy group (Group FVL, n = 54) according to the randomized number table method. Then, the success rate of the first intubation, the duration of intubation, the duration of positioning, the degree of exposure of the vocal cords (Cormack-Lehane grade), and the adverse reactions during intubation were recorded and analyzed.ResultsThe success rate of first-time intubation was significantly higher in the FVL group than in the F and VL groups (92.6% vs. 87.0% vs. 53.7%, P < 0.001), and the time of intubation in the FVL group was significantly shorter than that in the VL and F groups [(26.22 ± 9.34) s vs. (42.35 ± 11.21) s vs. (46.78 ± 21.96) s, P < 0.001)]. The positioning time in the FVL group was significantly shorter than that in the F and VL groups [(83.76 ± 15.18) s vs. (102.72 ± 21.89) s vs. (145.41 ± 20.12) s, F = 144.896, P < 0.001)].The number of patients with Cormack-Lehane grades I-II was significantly lower in the FVL group and the VL group than in the F group (88.9% vs. 77.8% vs. 59.3%, P < 0.05).The incidence of postoperative sore throat was significantly lower in the FVL group and the F group than in the VL group (22.4% vs. 27.6% vs. 50%, P < 0.001).ConclusionIn difficult airway patients with high airway risk indices who require double-lumen endotracheal intubation, visual laryngoscopy combined with fiberoptic bronchoscopy improved the success rate of first-time intubation and shortened the intubation and positioning time.Trial registrationChinese Clinical Trial Register (identifier: ChiCTR2300076304; Date of registration: September 29, 2023).

Comparison of the effects of perioperative intravenous infusions of esmolol and lidocaine on the quality of postoperative recovery in patients undergoing functional endoscopic sinus surgery: a randomized, double-blind, noninferiority study.

Perioperative intravenous lidocaine infusion can improve the quality of recovery (QoR) in patients undergoing functional endoscopic sinus surgery (FESS), but the effect of esmolol on recovery has been rarely studied. The aim of this study to compare the effects of esmolol and lidocaine on the QoR in patients with FESS. A total of 60 patients were randomly divided into Group E: intravenous esmolol (0.5mg/kg for 1min, followed by 3.0mg/kg/h); Group L: intravenous lidocaine (2.0mg/ kg for 10min, followed by 2mg/kg/h). The quality of recovery-15 (QoR-15) score was compared. Other parameters compared were the numeric rating pain scale (NRS), haemodynamic data, Surgical fieldconditions, intraoperative drug dosages, number of cases of remedial analgesia, time toawakening and incidence of postoperative sore throat (POST) as well aspostoperative nausea and vomiting (PONV). The mean difference in the QoR-15 score between Group E and Group L on postoperative day 1 (POD1) was - 1.37 (95% CI - 2.75 to 0.01; P < 0.001for noninferiority), indicating the noninferiority of esmolol. Haemodynamic changes and intraoperative nitroglycerine dosages were significantly lower in Group E than in Group L (P < 0.05). The scores of surgical field quality (SSFQ) was higher in Group E than in Group L (P < 0.05). Intravenous infusion of esmolol is not inferior to lidocaine in the quality of postoperative recovery in patients with FESS, and is more advantageous in terms of the quality of the surgical field, attenuation of intraoperative haemodynamic fluctuations, and postoperative awakening.

A Comparative Evaluation Of Efficacy Between Besdata, Ambu Ascope, And Macintosh Laryngoscope For Intubation In Adult General Surgical Patients

Background: In the context of general surgical operations, patient safety and procedure success are directly tied to the effectiveness of endotracheal intubation equipment. The comparative effectiveness of these devices in actual clinical situations is essential, notwithstanding the many technical breakthroughs that have been made. Objective: The purpose of this research was to compare the performance of three different intubation devices— the Besdata, the Ambu aScope, and the Macintosh Laryngoscope—in adult patients undergoing general surgical procedures. Methods: Between 2019 and 2022, researchers from Jawaharlal Nehru Medical College of AMU in Aligarh's Department of Anaesthesiology and Critical Care gathered data. Ninety patients were recruited, ranging in age from 20 to 70 years and in weight from 40 to 70 kg. After getting participants' consent, they were split into three groups at random. The Ambu aScope was used to intubate patients in Group A, the Besdata was used in Group B, and the Macintosh laryngoscope was used in Group M. Age, gender, height, and weight were recorded, as well as the participant's Mallampati status. Results: There was universal success with intubation using all three devices. Average intubation times were found to be quickest using the Ambu aScope, then the Besdata, and finally the Macintosh Laryngoscope. The incidence of postoperative sore throat was lowest in patients intubated using the Macintosh Laryngoscope and greatest in those intubated with the Besdata. Ambu aScope had the best percentage of success on the first attempt. There were no statistically significant variations between patients in terms of demographic information or Mallampati grade. Conclusion: While each of the three tools was useful, it also had its own set of advantages and disadvantages. It is important to consider the patient's anatomy, the clinician's level of expertise, and the clinical setting before settling on an intubation device.

Comparative Study between Preoperative Nebulization with Magnesium Sulfate and Ketamine in the Prevention of Postoperative Sore Throat during General Anesthesia with Endotracheal Intubation in Adults, a Randomized Double Blinded Clinical Trial

Abstract Background Post operative sore throat (POST) is a common complication following general anesthesia requiring endotracheal intubation with incidence ranges from 21% to 65%, also it may consider a minor complication, but if left unresolved, it produces significant agony and annoyance to the patients, if it was severe, it may be associated with hoarseness of voice or change of voice. Aim of the Work In our study we compare between ketamine nebulization and magnesium sulphate nebulization to evaluate their efficacy in decreasing incidence and severity of POST and concluding which drug is better. Patients and Methods This study is a randomized double blinded clinical trial, after obtaining approval from the research ethical committee of Faculty of Medicine, Ain Shams University, this study was conducted in the operating theaters of Ain Shams University Maternity Hospital. Patients were randomly allocated by computer generated randomization into two groups (M, K) each group 20 patients: group Magnesium (M): patients received preoperative nebulization with 250 mg magnesium sulfate in 5ml saline, group Ketamine (K): patients received preoperative nebulization with 50 mg ketamine in 5ml saline. Results The result of the study showed that preoperative nebulization with ketamine 50mg is more effective than preoperative nebulization with magnesium sulfate 250mg in reducing incidence and severity of post operative sore throat especially early after operation. Conclusion We conclude that preoperative nebulization with ketamine 50mg is more effective than preoperative nebulization with magnesium sulfate 250mg in reducing incidence and severity of post operative sore throat especially early after operation.

Effect of the intraoperative head hypsokinesis on sore throat after thyroid surgery: a randomized controlled trial.

Postoperative sore throat (POST) after thyroidectomy is a major concern.A roll is typically inserted under the shoulder to achieve head hypsokinesis and neck extension to better expose the surgical site during thyroid surgery. However, POST and impaired voice function have been attributed to neck overextension. This study aimed to explore the rational angle of head hypsokinesis that both reduced sore throat intensity and protects voice function after thyroid surgery. A total of 210 patients who underwent thyroidectomy were enrolled and randomized into high-tilt (Group H) and low-tilt angle groups (Group L). The primary outcome was the incidence of POST 6 h after surgery. Secondary outcomes included the severity of postoperative pharyngeal pain, voice function, swallowing pain, and coughing. The incidence of POST 6 h after thyroidectomy was significantly lower in Group L than that in Group H. In addition, the intensity of postoperative sore throat and swallowing pain was more severe in Group H. A lower degree of head hypsokinesis in Group L prevented transient postoperative voice injury. A lower degree of head hypsokinesis effectively mitigated sore throat severity after thyroidectomy and improved postoperative voice function. The trial was registered in the Chinese Clinical Trial Registry on 21 June 2022 (ChiCTR2200061329). The trial is registered at https://www.chictr.org.cn/showproj.html?proj=166254 .

Effectiveness of intracuff alkalinized lidocaine associated with intravenous dexamethasone in reducing laryngotracheal morbidity in children undergoing general anesthesia for tonsillectomy: a randomized controlled trial

BackgroundPostoperative sore throat is one of the main postoperative complaints in patients undergoing tonsillectomy. As the primary outcome, we aimed to determine whether endotracheal tube cuffs filled with alkalinized lidocaine are associated with a lower incidence of postoperative sore throat and anesthesia emergence phenomena in children undergoing tonsillectomy or adenotonsillectomy. We also assessed the potential additional benefits of IV dexamethasone in reducing postoperative laryngotracheal morbidity. MethodsThis is a clinical prospective, randomized, controlled trial. Patients were randomly allocated to one of four groups, as follows: air – endotracheal tube cuff filled with air; air/dex – endotracheal tube cuff filled with air and intravenous dexamethasone; lido – endotracheal tube cuff filled with alkalinized lidocaine; and lido/dex – endotracheal tube cuff filled with alkalinized lidocaine and intravenous dexamethasone. Perioperative hemodynamic parameters and the incidence of postoperative nausea and vomiting, coughing and hoarseness were recorded. Postoperative sore throat was assessed in the postanesthetic care unit and 24 hours post tracheal extubation. ResultsIn total, 154 children aged 4–12 years, ASA physical status I or II, undergoing general anesthesia for elective tonsillectomy and adenotonsillectomy, were assessed for postoperative sore throat in this study. The incidence of postoperative sore throat 24 hours after tracheal extubation was significantly lower in the lido/dex group compared to groups air and air/dex (p = 0.01). However, no additional reduction in these symptoms was observed from the intravenous administration of dexamethasone when comparing the lido and lido/dex groups. Similarly, there were no differences among groups regarding perioperative hemodynamic variables or postoperative nausea and vomiting, coughing, and hoarseness during the study period. ConclusionIntracuff alkalinized lidocaine, associated with intravenous dexamethasone, might be effective in reducing sore throat 24 hours post-tonsillectomy or adenotonsillectomy in children when compared to the use of air as the cuff insufflation media.

Comparison of nebulization with lignocaine and dexamethasone for attenuation of post-operative sore throat: A randomized controlled trial

Background: Post-operative sore throat (POST) is a very common anesthesia-related event which may hamper patient satisfaction and increase treatment cost. Aims and Objectives: This study aimed to compare the effectiveness of nebulization with dexamethasone and lignocaine to prevent POST. Materials and Methods: This randomized controlled study involved 135 patients randomly divided into three equal groups: Group D – (n=45) received 8 mg (2 mL) dexamethasone plus 3 mL of distilled water, Group L – (n=45) received 80 mg (4% lignocaine 2 mL) plus 3 mL distilled, and Group S – (n=45) received nebulization with 5 mL normal saline. Results: At 4 h postoperatively, the incidence of POST was 15.6% in the dexamethasone group, 33.3% in the lignocaine group, and 73.3% in the saline group. The score was significantly higher in the saline group (P=0.001) compared to the dexamethasone and lignocaine group, while it was comparable between dexamethasone and lignocaine group (P=0.188). Similarly, dexamethasone and lignocaine groups were comparable at immediately post-operative, 2, 8, 12, and 24 h post-operative time points. Post-operative hoarseness scores of all three groups were comparable at all-time points. A significant increase in the heart rate (HR) and mean arterial pressure (MAP) after intubation was observed in the saline and dexamethasone group as compared to the lignocaine group (P=0.001) while HR and MAP were comparable in dexamethasone and saline group (P=1.000). Conclusion: Dexamethasone and lignocaine nebulization are both effective and comparable prophylaxis for POST and lignocaine nebulization has added advantage of blunting pressor response to endotracheal intubation over dexamethasone nebulization.

Comparison of nebulization with lignocaine and dexamethasone for attenuation of post-operative sore throat: A randomized controlled trial

Background: Post-operative sore throat (POST) is a very common anesthesia-related event which may hamper patient satisfaction and increase treatment cost. Aims and Objectives: This study aimed to compare the effectiveness of nebulization with dexamethasone and lignocaine to prevent POST. Materials and Methods: This randomized controlled study involved 135 patients randomly divided into three equal groups: Group D – (n=45) received 8 mg (2 mL) dexamethasone plus 3 mL of distilled water, Group L – (n=45) received 80 mg (4% lignocaine 2 mL) plus 3 mL distilled, and Group S – (n=45) received nebulization with 5 mL normal saline. Results: At 4 h postoperatively, the incidence of POST was 15.6% in the dexamethasone group, 33.3% in the lignocaine group, and 73.3% in the saline group. The score was significantly higher in the saline group (P=0.001) compared to the dexamethasone and lignocaine group, while it was comparable between dexamethasone and lignocaine group (P=0.188). Similarly, dexamethasone and lignocaine groups were comparable at immediately post-operative, 2, 8, 12, and 24 h post-operative time points. Post-operative hoarseness scores of all three groups were comparable at all-time points. A significant increase in the heart rate (HR) and mean arterial pressure (MAP) after intubation was observed in the saline and dexamethasone group as compared to the lignocaine group (P=0.001) while HR and MAP were comparable in dexamethasone and saline group (P=1.000). Conclusion: Dexamethasone and lignocaine nebulization are both effective and comparable prophylaxis for POST and lignocaine nebulization has added advantage of blunting pressor response to endotracheal intubation over dexamethasone nebulization.

Educational Intervention Can Improve the Pilot Balloon Palpation Method of Tracheal Tube Cuff Pressure Monitoring: An Experimental Study.

Considerable morbidity is attributable to inappropriate tracheal cuff pressure. An earlier study undertaken in our hospital revealed that a normal cuff pressure of 20-30 cm H2O was achieved in only 6% of intubated patients using subjective estimation methods. To determine whether a training intervention could improve the accuracy of the subjective estimation method in our tracheal cuff monitoring. A 1-day training session was conducted in April 2022 for our anaesthesia providers. The cuffs of different sizes of endotracheal tubes were inflated to 25 cm H2O, and each staff was requested to feel the turgor of the pilot balloon. Subsequently, anaesthesia providers used pilot balloon palpation for the regulation of the tracheal cuff pressure in consecutive patients undergoing general anaesthesia with endotracheal intubation. During each intubation, a manometer was used to crosscheck the inflated cuff pressure objectively. The incidence of post-operative sore throat was also evaluated. The obtained outcomes were compared with pre-intervention data obtained from an earlier study conducted in the health facility from October 2020 to September 2021. Significant differences were considered when P < 0.05. The mean tracheal cuff pressure was improved post-intervention (49.2 ± 24.1 cm H2O versus 77.1 ± 31.1 cm H2O; P < 0.001). A significantly higher proportion of tracheal cuffs (20%; 31/156) were inflated within the normal range compared to 6% (9/141) prior to the intervention (P = 0.003). Fewer patients developed post-operative sore throat following the educational intervention (32.8%; 41/125) versus pre-intervention (47.7%; 53/111; P = 0.019). The educational intervention improved the safety of tracheal cuff management, which could positively impact airway management, especially in poor resource settings without cuff manometers.

Comparison between intravenous lidocaine and dexamethasone in reducing postoperative sore throat after endotracheal extubation at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia; a prospective cohort study

BackgroundPost-operative sore throat is the common complaint and uncomfortable side effect in patients receiving general anesthesia with endotracheal intubation. Drugs with analgesic and anti-inflammatory properties, like steroids and local anesthetics, are the best options for postoperative sore throat prophylaxis. Therefore, this study aimed to compare the effects of intravenous lidocaine and dexamethasone in reducing postoperative sore throat following endotracheal extubation at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, from January 1 to March 30, 2023 G.C.MethodsA prospective cohort study was carried out at Tikur Anbessa Specialized Hospital. Data from 50 patients in the lidocaine (1.5 mg/kg), 50 in the dexamethasone (8 mg), and 49 in the control groups were analyzed. The data were collected using observation based on structured questionnaires. A systematic random sampling technique was applied to select respondents. The data were entered into EpiData version 4.6.0.6 and transferred to STATA version 17 statistical software for analysis. A comparison of continuous data among the groups were performed using a one-way ANOVA test for parametric data. The Kruskal–Wallis rank test was used for non-parametric data. Associations between variables were tested using chi-squared test, Fisher’s exact test, and binary logistic regression. Bivariable and multivariable logistic regression was used to determine degree of association.ResultsThe incidence of POST was 40%, 32%, and 57.1% in the lidocaine, dexamethasone, and control groups, respectively (P = .0356). Dexamethasone reduced the incidence of POST during the first 24 h (AOR: 0.374, 95% CI: 0.149–0.939). However, no difference was observed in the severity of POST at 3 h (p = 0.130), 6 h (p = 0.096), 12 h (p = 0.313), and 24 h (p = 0.525) of the post-extubation period among the three groups. IV lidocaine did not effectively reduce the incidence and severity of postoperative sore throat at different time intervals.Conclusion and recommendationIntravenous dexamethasone is more effective than intravenous lidocaine in reducing the incidence of postoperative sore throat among the groups. Based on these findings, intravenous dexamethasone is recommended to decrease the incidence of postoperative sore throat.

Effects of Different Agents of the Lubrication of i-gel Airway on the Incidence of Postoperative Sore Throat: A Prospective Randomised Controlled Trial.

The aim of this study is to compare the effect of different lubricating agents used with the i-gel® laryngeal mask airwayon the incidence of postoperative sore throat. After obtaining institutional ethics approval, this prospective trial was conducted on 150 patients who were scheduled for minor surgical procedures. The study population was placed in three groups of 50 each, after randomization with computer-generated random numbers, based on the lubricant used (Group LJ: with lignocaine jelly as the lubricant, Group WJ: with water-based jelly as a lubricant, Group NS: with 0.9% normal saline as a lubricant). The time taken to secure the airway (from insertion to the first end-tidal carbon dioxide (ETCO2) tracing and five-point auscultation) and the number of attempts were noted. During extubation, blood staining was noted. In the postoperative period, sore throat was monitored with the numerical rating scale for the first 24 hours. Postoperative hoarseness of voice, cough and difficulty in swallowing were the other parameters noted. The results were entered in a standard spread sheet. Statistical analysis was done using JASP version 0.18.3.0 using the independent samples t-test and the Chi-square test for quantitative variables. All three groups were comparable in terms of demography (p > 0.05). The time taken to insertion, number of attempts and securing of the airway were also comparable amongst the three groups (p > 0.05). Blood staining during LMA removal was comparable between the three groups (p > 0.05). In the postoperative period, sore throat was comparable between the three groups (p > 0.05). The incidence of hoarseness of voice in the postoperative period however was more significant in Group LJ when compared to the other two (p < 0.05). Postoperative swallowing discomfort was also significantly higher in Group LJ than in the other two groups (p < 0.05). We conclude that lignocaine jelly, water-based jelly and normal saline used as lubricating agents on the i-gel airway did not show a difference in the incidence of postoperative sore throat. Lignocaine jelly was associated with a higher incidence of hoarseness of voice and swallowing discomfort when compared to the other lubricants.