Occurrence Of Postoperative Sore Throat Research Articles

Ease of endotracheal intubation with the conventional polyvinyl chloride endotracheal tube versus wire-reinforced flexometallic tube through the intubating laryngeal mask airway: A comparative study.

The aim of our study was to compare the ease of intubation when using conventional PVC tubes versus the wire-reinforced flexometallic tubes with the ILMA-FastrachTM. The number of attempts, time taken and additional maneuvers were noted. Intra-operative hemodynamic changes, post-operative sore throat, bleeding and hoarseness of voice was recorded over a period of 24 hours. After informed consent, 60 ASA I-II patients undergoing elective surgeries under general anesthesia were allocated to undergo blind intubation with the PVC tube or the wire-reinforced flexometallic tube. More attempts were required for successful intubation using the wire-reinforced tube than the PVC tube with 76.7% passing in the first attempt in the PVC, and 53.3% passing in the first attempt in the flexometallic group. (P = 0.4). Average time for intubation in the PVC group: 28.24 ± 7.22 seconds. Average time for intubation in the flexometallic tube: 45.8 ± 15.78 sec. Occurrence of post-operative sore throat was 13.3% in the PVC group and 26.6% in the flexometallic group, with minimal hoarseness of voice 3.3% in the PVC group and 10% in the flexometallic group. There was also a slightly higher hemodynamic response in those who were intubated with the flexometallic tube than a PVC tube. Intubating via the ILMA-Fastrach with the PVC tube offered better intubating conditions with regards to lesser time taken, lesser attempts, less manipulation, and less hemodynamic variations as compared to the patients who were intubated using the wire-reinforced tube.

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.

Comparision of Laryngeal Mask Airway and Endotracheal Tube for Post-Operative Sore Throat and Hoarseness of Voice

Objective: To compare effectiveness of Laryngeal mask airway versus endotracheal tube to evaluate post-operative sore throat and hoarseness of voice among anesthetized adults. Study Design: Prospective comparative study Place and Duration of Study: Operation Theatre Complex, Surgical Ward 1 and 2, Combined Military Hospital, Lahore Pakistan, from Jun to Oct 2020. Methodology: A total of 70 patients of both gender undergoing elective surgeries were included. Afterwards a lottery method was applied to segregate patients randomly into Group-L and Group-T. In Group-L, airway was secured with laryngeal mask airway while in Group-T, airway was secured with endotracheal tube. Hoarseness of voice was evaluated at time of extubation and 24 hours post extubation. Results: Demographic data was comparable in both groups. Mean time of anesthesia was 71.31±22.87 and 82.86±32.34 minutes for Group-L and Group-T respectively with p-value of 0.09. Sore throat was seen in 12(34.29%) patients in Group-L as compared to 19(51.43%) in Group-T (p-value=0.094). Hoarseness of voice was seen in 3(8.57%) patients in Group-L as compare to 13(37.14%) in Group-T (p-value= 0.005). Conclusion: There was less occurrence of postoperative sore throat and hoarseness of voice in patients undergoing elective surgery with laryngeal mask airway as compared with endotracheal tube.

Incidence of Postoperative Sore Throat and Associated Factors Among Pediatric Patients Undergoing Surgery Under General Anesthesia at Hawassa University Comprehensive Specialized Hospital, a Prospective Cohort Study.

Postoperative sore throat is one of the common postoperative complications following general anesthesia. Postoperative sore throat causes decreased patient satisfaction, and it affects patients' well-being after surgery, thus identifying its incidence and predictors helps to distinguish the preventable causes of postoperative sore throat. This study aimed to assess the incidence and associated factors of postoperative sore throat among pediatric patients undergoing surgery under general anesthesia at Hawassa university comprehensive specialized hospital. A prospective cohort study was conducted among children in the age range 6-16 years old who underwent emergency and elective surgical procedures under general anesthesia. Data were entered and analyzed using SPSS version 26 software packages. Univariate and multivariate analyses were performed to investigate the independent predictors. The presence and severity of postoperative sore throat were assessed by using a four-point categorical pain scale at the 2nd, 6th, 12th, and 24th-hour postoperative time. A total of 102 children were recruited in this study, from which 27 children (26.5%) complained of sore throat postoperatively. This study found that endotracheal intubation (P value: 0.030; AOR: 3.155; 95% CI [1.114-8.933]) and several attempts greater than one (P value: 0.027 and AOR: 4.890; 95% CI: [1.203-19.883]) had statistically significant association with a postoperative sore throat. The overall incidence of postoperative sore throat was 26.5%. Endotracheal intubation and the number of attempts greater than one were independent factors that were significantly associated with the occurrence of postoperative sore throat in this study.

The Comparison of Inflation of Cuff with 1% Propofol, 4% Lignocaine, or 0.9% Saline on Laryngotracheal Morbidity.

While administering general anesthesia requiring endotracheal intubation, it is a common practice to inflate the cuff with air. Continuous pressure exerted by cuff on mucosa may lead to postoperative complaints such as sore throat, cough, and dysphagia, which are very disturbing to the patient. Hence, we hypothesized that inflation of cuff with propofol may reduce the incidence of these complications as a result of cushioning effect as well as non-diffusion of nitrous oxide into it. Our aim was to compare the effects of inflation of endotracheal tube cuff with 0.9% saline, 4% lignocaine, and 1% propofol on the incidence of postoperative morbidity in terms of cough, sore throat, dysphonia, and dysphagia with general anesthesia using nitrous oxide. Patients scheduled for elective surgery under general anesthesia were randomly allocated into four equal groups of thirty each as per cuff inflation media: air (Group A), 0.9% saline (Group S), 4% lidocaine (Group L), and 1% propofol (Group P). The incidence of cough was noted at 15, 30 and 60 min after extubating. The occurrence and severity of postoperative sore throat (POST) was evaluated at 2, 6, and 24 h after extubating. The incidence of cough was maximum in Group A and minimum in Group P (P < 0.05). The occurrence of POST was highest in Group A, followed by Group S and Group L, and least in Group P. The hemodynamic parameters were comparable with no statistical difference in all the four groups (P < 0.05). The intracuff 1% propofol is superior to 4% xylocaine and normal saline in the prevention of cough and sore throat postoperatively, whereas inflation of cuff with air leads to maximum incidence of these complications.

Comparison between Two Endotracheal Tube Cuff Inflation Methods; Just-Seal Vs. Stethoscope-Guided.

The Endotracheal Tube (ETT) cuff performs a critical function of sealing the airway during positive pressure ventilation. There is a narrow range of cuff pressure required to maintain a functionally safe seal without exceeding capillary blood pressure. We aimed to compare Just-Seal (JS) and Stethoscope-Guided (SG) method of ETT cuff inflation with respect to the volume of air required to inflate the cuff, the manometric cuff pressure achieved and also to assess for the occurrence of postoperative sore throat after extubation in both the groups. It was a prospective observational study done in a Tertiary Teaching Public Hospital over a period of 1½ years on 100 patients with 50 each in two groups; JS or SG method of cuff inflation. SPSS Version 17 was used for data analysis. Statistically significant difference (p-value of less than 0.05) was noted between the two methods based on the volume of air injected into the cuff {the mean volume injected in JS was 6.79 ml and in the SG was 4.95 ml with p=5.71E-16 (< 0.05)} and cuff pressure achieved {mean cuff pressure achieved was 38.80 cm H2O in the JS and 29.64 cm H2O in SG with p=2.29E-14 (< 0.05)}. The incidence of post extubation sore throat was 54% (27 in 50) in the JS group and only 12% (6 in 50) in the SG; p= 0.00000797. ETT cuff inflation guided by a stethoscope is an effective technique for ensuring appropriate cuff pressures thus accomplishing the objective of providing safe and superior quality care of the patient both during and after anaesthesia and reducing the likelihood of even minimal risk complications that may still have legal implications.

Pharyngolaryngeal discomfort after use of LMA among patients receiving intermittent positive pressure ventilation and that breathing spontaneously

Objective: To evaluate the occurrence of postoperative sore throat after the use of LMA among patients undergoing surgery on intermittent positive pressure ventilation and those on spontaneous mode. Methods: hundred adult patients of ASA I or II status were included and divided into two equal groups. Group I patients were randomly assigned for positive pressure ventilation and group II patients for spontaneous breathing. Anaesthesia was administered with propofol, oxygen nitrous oxide and halothane. The LMA of appropriate size was placed.After completion of surgery, LMA was removed when the patient regained deglutition reflex. Patient was questioned postoperatively for variables of sore throat for three days. Results: In group I, 12% patients complained of mild sore throat in comparison to group II where 6% suffered from mild sore throat (p&gt;0.05). There was no difference in the discomfort levels among males and females. Conclusion: Pharyngolaryngeal discomfort is less after use of LMA under spontaneous ve ntilation in comparison to controlled ventilation.

Insertion characteristics of three supraglottic airway devices: A randomized comparative trial

Background I-gel is a new single-use supraglottic airway device without an inflatable cuff. The aim of this study was to compare I-gel, a Proseal laryngeal mask airway (PLMA), and a laryngeal tube (LT) for ease of insertion, hemodynamic effects of insertion, and associated airway morbidity. Patients and methods Seventy-five adult patients, both sexes, were assigned randomly to I-gel (I), PLMA (P), and LT (L) groups according to the supraglottic device applied. Insertion time, airway sealing pressure, insertion success rate, insertion-associated hemodynamic effects, ease of gastric tube insertion, and associated airway morbidities were assessed. Results Demographic data and duration of both surgery and anesthesia in the three groups were comparable. Insertion time (s) was significantly shorter in group I (18.9 ± 0.9) compared with group P (26.2 ± 1.1) and group L (26.2 ± 1.0). Airway sealing pressure (cm H 2 O) was higher in group P (29.6 ± 1.2) compared with group I (26.0 ± 1.0) and group L (22.9 ± 0.9). The success rate at the first insertion attempt was higher in group I (96.0%) compared with group P (84.0%) and group L (88%). Blood-stained devices and occurrence of postoperative sore throat were lower in group I than the P and L group, with no significant differences. Heart rate, mean arterial pressure, and cardiac index were significantly increased in the postinsertion period in the P and L group compared with group I. Conclusion In the I-gel group, higher insertion success rate, and lower both hemodynamic changes and airway morbidities were noted compared with PLMA and LT. However, airway sealing ability was better with PLMA.

Does the incidence of sore throat postoperatively increase with the use of a traditional intubation blade or the GlideScope?

Study ObjectiveThe GlideScope video-guided laryngoscope is an alternative standard of care for rescue laryngoscopies when direct laryngoscopy is unsuccessful. During postoperative checks by an anesthesiologist, it was noticed that patients who reported sore throat often required GlideScope laryngoscopy. Consequently, it is difficult to determine whether postoperative sore throats are caused by irritation inflicted by multiple laryngoscopic attempts or the actual utilization of the GlideScope itself. The goal of this study was to determine whether the use of the GlideScope leads to a greater or lesser incidence of sore throat when compared with traditional laryngoscope blades used for intubation. DesignEligible patients scheduled for elective inpatient surgeries requiring endotracheal tube intubation were enrolled into this single-blinded prospective cohort study. χ2 Test, Fisher exact test, and t tests were used to compare differences across the primary end point and other demographic categories. SettingOperating rooms and postanesthesia recovery unit, Albany Medical Center, Albany, NY. PatientsThere were a total of 151 patients with American Society of Anesthesiologists grades 1 to 3 included in the study. InterventionsEighty-one patients were randomized to a control group that received traditional laryngoscopy via Macintosh/Miller blades and 70 patients received video-guided intubation via the GlideScope. MeasurementsThe incidence of postoperative sore throat was recorded via a yes/no questionnaire within 24 hours after extubation. Secondary parameters such as provider type, sex, and perceived difficulty were also recorded. Main resultsThere was no significant difference in the proportion of patients reporting sore throat by type of blade used (Mac/Miller 36.3% vs GlideScope 32.4%, P = .619). For secondary outcomes, women were significantly more likely to report sore throat as compared with men (men 24.3% vs women 43.2%, P = .015), and the provider type was significantly associated with the occurrence of postoperative sore throat (attendings 26.8% vs certified registered nurse anesthetists 52.3% vs third-year clinical anesthesia residents 30%, P = .012). ConclusionsUse of the GlideScope videolaryngoscopy was not significantly associated with increased occurrence of postoperative sore throat when compared with traditional intubation techniques. Our results may enable more trainees to acquire intubation skills with the GlideScope during an initial intubation attempt in patients with American Society of Anesthesiologist grades 1 to 3, with optimization of patient satisfaction in respect to postoperative sore throats. In addition, a provider's choice of intubation technique based on either Macintosh/Miller blades or the GlideScope does not significantly impact a patient's risk of postoperative sore throat.

Efficacy of Ketamine Gargle in Attenuating Postoperative Sore Throat

Introduction: Postoperative sore throat (POST) is a common complication of general anesthesia with endotracheal intubation that affects the patient satisfaction after surgery. The aim of the study was to compare the effectiveness of ketamine gargle with placebo in preventing POST after endotracheal intubation.&#x0D; Methods: Sixty eight patients scheduled for elective surgery under general anesthesia were enrolled in this study. Patients were randomly allocated into two groups, 33 in study group and 35 in control group. Study group patients were asked to gargle with ketamine (50 mg in 1 ml mixed with 29 ml of drinking water) 10 minutes before induction for 30 seconds. Controls were made to do so with 30 ml of drinking water. POST was graded at one, two, four, and 24 hrs after operation on a four-point scale (0-3). The outcome measures were compared between two groups in terms of occurrence of POST and severity of POST at one, two, four, and 24 hr to determine the efficacy of ketamine.&#x0D; Results: Occurrence of POST was significantly less in study group at four hours. Severity of POST was significantly low in study group at one, two and four hours as compared to that in controls. It was comparable at 24 hours.&#x0D; Conclusion: Ketamine gargle significantly reduced the occurrence and severity of POST.

Incidence of sore throat in children following use of flexible laryngeal mask airways – impact of an introducer device

Insertion of a flexible laryngeal mask airway (FLMA) is more difficult and therefore might result in a higher risk for trauma to the upper airway. To facilitate the insertion of FLMA, the use of an introducer device (Portex Limited, Hythe, Kent, UK) was promoted. However, the impact of the use of this device on the occurrence of postoperative sore throat is unknown. Four hundred children (3-21 years) undergoing elective ambulatory surgery were consecutively included in this study. In 196 cases, the FLMA was inserted using an introducer device. The FLMA cuff was then inflated and the pressure adjusted to below 60 cmH(2)O (according to manufacturers guidelines) using a calibrated cuff manometer (Portex Limited). Three types of FLMA were available: FLMA classic, FLMA unique (both FLMA PacMed, Richmond, Victoria, Australia) and FLMA ProBreathe (Well Lead Medical Co Ltd., Hualong, Guangzhou, China). Prior to discharge, patients' pain was assessed using an age appropriate scale. Thirteen children (3.3%) developed sore throat, two (0.5%) sore neck and three (0.75%) sore jaw. Of those that developed sore throat, seven had a FLMA inserted with an introducer, six without an introducer. Using a laryngeal mask airways (LMA) with a polyvinyl chloride (PVC), surface was associated with a higher risk for sore throat compared with an LMA with a silicone surface (P = 0.0002). In this study with controlled low cuff pressures, the incidence of sore throat was low. The use of an introducer device did not affect the rate of sore throat.

Comparison of the Laryngeal Mask (LMA™) and Laryngeal Tube (LT®) with the Perilaryngeal Airway (CobraPLA®) in Brief Paediatric Surgical Procedures

We compared the laryngeal mask airway (LMA) and the laryngeal tube (LT) with the perilaryngeal airway (CobraPLA, PLA) in anaesthetised, paralysed children having brief surgical procedures. After obtaining informed consent, 90 paediatric ASA Status 1 and 2 patients awaiting short surgical procedures were randomised to have their airways managed with an LMA, LT or PLA. Anaesthesia was induced with sevoflurane (2.5 to 4%) and muscle paralysis with mivacurium (0.2 mg/kg intravenously). The number of insertion attempts, time taken to insert the device, haemodynamic responses to insertion (mean arterial blood pressure, heart rate, pulse oximetry and end-tidal CO2), clinical performance and occurrence of postoperative sore throat were recorded. When the airway device was removed, it was examined for visible blood. Patients and parents were asked about the occurrence of sore throat, dysphonia and dysphagia 24 hours postoperatively. Heart rate, mean arterial blood pressure, pulse oximetry and end tidal CO2 did not differ among the groups. Insertion times for the devices were similar (LMA: 19+/-11 seconds, LT 21+/-12 seconds, PLA: 18+/-12 seconds), as were the rates of successful insertion at first attempt (LMA 66.7%; LT 70.0%; PLA 73.3%). The number and type of airway interventions to achieve an effective airway were comparable. When the airways were removed, positive blood traces were noted on 20% of the LMAs, 20% of the PLAs and 10% of the LTs. Haemodynamic, ventilation and oxygenation variables throughout the surgery were similar with LMA, LT and PLA and there were no significant differences in insertion time or signs or symptoms of mucosal trauma when these devices were used in paralysed children.

Comparison of the laryngeal mask (LMA™) and laryngeal tube (LT®) with the new perilaryngeal airway (CobraPLA®) in short surgical procedures

We compared the laryngeal mask airway (LMA) and the laryngeal tube (LT) with the newly introduced perilaryngeal airway (CobraPLA, PLA) with regard to haemodynamic responses induced by airway insertion, clinical performance and occurrence of postoperative sore throat after short surgical procedures. After premedication, 90 ASA I-II patients awaiting short surgical procedures were randomized to receive, LMA, LT or PLA. Anaesthesia was induced with intravenous propofol (2.5 mg kg(-1)) and mivacurium (0.2 mg kg(-1)). Number of attempts, time of insertion of the device, any other unwanted effect, mean aterial pressure, heart rate, oxygen saturation and end-tidal carbon dioxide were recorded. At the end of surgery, the cuff of the device was immediately deflated and the airway device was removed. The device was examined and noted for the presence of visible blood. Patients were asked to rate their throat soreness, dysphonia and dysphagia 1 and 24 h postoperatively. There were no differences in haemodynamic variables. Insertion times for the devices were similar (LMA: 20 +/- 11 s, LT: 19 +/- 14 s and PLA: 21 +/- 12 s.) The success rates at first insertion were lower in the (LMA group (57%) when compared with the PLA (97%, P < 0.05). The number and type of airway interventions for achieving an effective airway were similar. When the airways were removed 50% of the PLA devices had positive blood traces, while only 17% of the LMA and LT devices had positive blood traces (P < 0.01). Fifty percent of the patients suffered from a sore throat in the PLA group, which was significantly higher than in the LMA and LT groups (P < 0.05). We conclude that haemodynamic, ventilation and oxygenation variables throughout the surgery were similar with, LMA, LT and PLA, but LT and PLA were easier to insert; LMA and LT caused less mucosal trauma.

Postoperative Sore Throat

The incidence of postoperative sore throat was evaluated prospectively in 203 orotracheally intubated patients undergoing general anesthesia for surgical procedures. Patients were randomly assigned to have either a plastic oropharyngeal airway or a gauze bite-block in place during the operation and were evaluated for the occurrence of postoperative sore throat by questionnaire the day after surgery. The incidence of postoperative sore throat was 35.2% in the oropharyngeal airway group and 42.5% in the gauze bite-block group, not a statistically significant difference (P greater than 0.05). The incidence of postoperative sore throat was significantly higher when blood was noted on the airway instruments (64.5%) than when it was not (30.9%) (P less than 0.01). There was an association, although not statistically significant, between the incidence of postoperative sore throat and intubation by an anesthesia resident with less than 1 yr experience (P = 0.064). The data from this study indicate that the intraoperative use of hard plastic oropharyngeal airways, compared with the use of soft gauze bite-blocks, does not increase the incidence of postoperative sore throat. These data also suggest that pharyngeal trauma may contribute significantly to the development of postoperative sore throat. We suggest that aggressive oropharyngeal suctioning may contribute to this pharyngeal trauma.