Overall Incidence Of Postoperative Sore Throat Research Articles

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).

Comparative Evaluation of Preoperative Paracetamol and a Combination of Paracetamol with Nebulized or Intravenous Dexamethasone for Prevention of Postoperative Sore Throat

ABSTRACT Background and Aims: Postoperative sore throat (POST) is a common complication following general anesthesia with tracheal intubation that increases patient morbidity. We evaluated the effect of preoperative administration of IV paracetamol and a combination of paracetamol with nebulized or IV dexamethasone on the incidence of POST (primary objective), hoarseness of voice and cough (secondary objectives) in adult patients. Methods: In a randomized, double-blind study in a tertiary care hospital, 150 patients undergoing laparoscopic cholecystectomy under general anesthesia with tracheal intubation were divided into three groups (n = 50): Group P received IV paracetamol 1 g infusion; Group I received IV dexamethasone 8 mg and IV paracetamol 1 g infusion; and Group N received nebulized dexamethasone 8 mg and IV Paracetamol 1 g infusion. The incidence and severity of POST, hoarseness and cough were assessed at various time-points for 24 hours after surgery. Results: The overall incidence of POST was 72%, 18%, and 24% in groups P, I, and N, respectively; P &lt; .0001. The severity of POST was significantly less in groups I and N compared with group P; both P &lt; .0001. The incidence of postoperative hoarseness was comparable between the three groups; P = 0.216. The incidence and severity of postoperative cough were significantly higher in group P compared with group I; P = 0.016. Statistical calculations were done using SPSS 21 version program for Windows. Conclusions: Prophylactic administration of both nebulized and IV dexamethasone 8 mg in combination with IV paracetamol was effective in decreasing the incidence and severity of POST in adult patients undergoing laparoscopic cholecystectomy under general anesthesia with tracheal intubation.

Nebulized dexmedetomidine for preventing postoperative sore throat after tracheal intubation: a randomized, double‐blind clinical trial

Background and Objective: Endotracheal intubation is part of general anesthesia, and probably the most commonly performed airway related procedure in operating rooms as well as intensive care units. It may be a causative factor in about 74% of patients who experience postoperative sore throat (POST) due to airway mucosal injury. This double-blind randomized clinical trial assessed the effectiveness of nebulized dexmedetomidine in preventing POST by comparing with a control group.&#x0D; Methodology: In this randomized, double‐blind clinical trial, we enrolled 56 patients, who were to undergo general anesthesia with endotracheal intubation. Patients were randomly divided into two groups of 28 each. Group A received dexmedetomidine nebulization, and Group B had normal saline nebulization, both for 15 min before induction. POST was assessed at 1, 2, 4, 6, 12, and 24 h after extubation using a POST scale. Data were collected and statistically analyzed&#x0D; Results: The overall incidence of POST was 60.3%: Control group experienced POST by 28 (96.6%) patients, compared to 7 (24,1%) patients in dexmedetomidine group (P = 0.0001). Differences were significant at recording times post-operatively. The dexmedetomidine group had milder sore throats, less coughing, and lower heart rates/blood pressures compared to the control group.&#x0D; Conclusion: Patients who were nebulized with dexmedetomidine, experienced lower rates and intensity of postoperative sore throat compared to the control group. Administering dexmedetomidine via nebulization before intubation can be considered a safe and effective method for reducing postoperative sore throat, with less postintubation hemodynamic derangement.&#x0D; Abbreviations: ETT: Endotracheal Tube; GA: General Anesthesia; IL: Interleukin; MAC: Minimum Alveolar Concentration; N2O: Nitic Oxide; PACU: Post Anesthesia Care Unit; PONV- Postoperative Nausea and Vomiting; POST- Postoperative Sore Throat; TNF: Tumor Necrosis Factor&#x0D; Key words: Dexmedetomidine; Endotracheal Intubation; Anaesthesia, General; Nebulization; Postoperative sore throat&#x0D; Citation: Pradian E, Kestriani SS ND, Ritonga DZ. Nebulized dexmedetomidine for preventing postoperative sore throat after tracheal intubation: a randomized, double‐blind clinical trial. Anaesth. pain intensive care 2023;27(6):737−744. DOI: 10.35975/apic.v27i6.2348&#x0D; Received: Aug 28, 2023; Revised: Oct 21, 2023; Accepted: Oct 21, 2023

Pre-Operative, Prophylactic Use of Oral Zinc Tablet in the Management of Post-Operative Sore Throat

Background: Postoperative sore throat (POST) is considered to be quite common complaint. Its symptoms tend to improve with time, but use of oral zinc lozenge has been shown to reduce the incidence and severity of POST. The aim of the present study was to find the efficacy of oral zinc sulfate, given 30 min preoperatively, in reducing POST, primarily caused by endotracheal intubation, till 24 hours after surgery. Method: A prospective, randomized, double-blinded, placebo-control-trial study was conducted on 80 patients, further divided into two groups of 40 patients each, between the age group of 18-60 years, of either gender, in Super Specialty Hospital, GMC Jammu, over a period of 6-months. The two groups received either dispersible zinc tablet or a placebo. The severity of POST was graded on a 4-point scale ranging from 0 to 3 and evaluation was repeated at 30 min, 2, 4, and 24 hour, postoperatively. Results: The difference in severity of sore throat was found to be statistically significant at all evaluation time intervals, except at 24 hours, which was quite lower in Zinc group. The overall incidence of POST in Zinc group was 26.3%, which was significantly higher at 50% in placebo group. Conclusion: A dose 40 mg zinc dispersible tablet, equivalent to 40 mg elemental zinc, given 30 min before surgery, effectively reduced the incidence and severity of POST. Keywords: Post Operative Sore Throat, Oral Zinc Lozenge, Endotracheal Intubation.

Effect of Preoperative Nebulized Ketamine on Incidence and Severity of Postoperative Sore Throat in Patient Undergoing General Anaesthesia with Endotracheal Intubation

Introduction Postoperative sore throat (POST) has a reported incidence of up to 62% following general anaesthesia. POST was rated by patients as the eighth most undesirable outcome in the postoperative period. The objective of this study was to compare the incidence and severity of postoperative sore throat after saline and ketamine nebulization in patients undergoing general anaesthesia with endotracheal intubation.&#x0D; MethodsThe study was prospective double blinded randomized controlled trial . One hundred patients belonging to American Society of Anesthesiologists physical status I–II undergoing surgery under general anaesthesia with endotracheal intubation were randomized into two groups; group Saline (S) received nebulization with 5 ml of normal saline and group Ketamine (K) received nebulization with 1 ml of ketamine of concentration 50 mg/ml mixed with 4 ml saline. POST was assessed at zero hour, two hour, four hour, six hour, eight hour and 24 hour.&#x0D; ResultsThe overall incidence of POST was 28%. Twenty two (44%) patients in group S and six (12%) patients in group K had postoperative sore throat at some point of the study. The POST was significantly reduced in group K at zero hour 3(6%), two hour 3(6%), four hour 4(8%), six hour 5(10%) and eight hour 3(6%) with p value &lt;0.05 . The severity of POST was also significantly decreased in group K at zero hour, two hour, four hour, six hour, eight hour with p value &lt;0.05.&#x0D; ConclusionPreoperative nebulization with ketamine reduces the incidence and severity of POST after general anaesthesia with endotracheal intubation.

Dexmedetomidine nebulisation attenuates post-operative sore throat in patients undergoing thyroidectomy: A randomised, double-blind, comparative study with nebulised ketamine.

Background and Aims:Endotracheal intubation is the predominant cause of airway mucosal injury, resulting in post-operative sore throat (POST), with an incidence of 20-74%, which brings immense anguish to patients. This study was conducted to evaluate and compare the efficacy of nebulised dexmedetomidine and ketamine in decreasing POST in patients undergoing thyroidectomy.Methods:Patients were randomly allocated into two groups of 50 each; Group 1 received ketamine 50mg (1mL) with 4mL saline nebulisation, while Group 2 received dexmedetomidine 50μg (1mL) with 4mL saline nebulisation for 15 min. GA was administered 15 min after completing nebulisation. POST monitoring was done at 0,2,4,6,12 and 24h after extubation. POST was graded on a four-point scale (0-3). The statistical analysis were performed using Statistical Package for Social Sciences (SPSS) software version 17.0. Fisher Exact-t-test, Chi square test, Student t-test, Paired t test and repeated measure analysis of variance (ANOVA) were used for analysis.Results:The overall incidence of POST in this study was 17%: POST was experienced by seven patients (14.3%) in ketamine and 10 patients (20.4%) in dexmedetomidine group (P = 0.424). There was no statistically significant difference in the incidence of POST between the two groups at 0,2,4,6,12 and 24h post-operatively. Severity of sore throat was also significantly lower in both groups at all time points. A statistically significant increase in heart rate, systolic and diastolic blood pressure was noted in ketamine group, post nebulisation.Conclusion:Pre-operative dexmedetomidine nebulisation can be utilised as a safe and ideal alternative to ketamine nebulisation in attenuating POST, with less haemodynamic derangement.

The influence of high-dose intraoperative remifentanil on postoperative sore throat: a prospective randomized study: A CONSORT compliant article.

Background:Endotracheal intubation for general anesthesia causes postoperative sore throat (POST). This study is designed to evaluate the effect of high-dose remifentanil on the incidence of POST in patients after general anesthesia.Methods:Ninety-two patients scheduled for orthopedic lower extremity surgery under general anesthesia were randomly assigned into 1 of 2 groups. In the high-dose remifentanil (HR) group (n = 46), remifentanil was infused at a rate of 0.25 μg/kg/min and subsequently increased or decreased by 0.05 μg/kg/min per clinical demand. In the low-dose remifentanil (LR) group (n = 46), remifentanil was infused at a rate of 0.05 μg/kg/min. The incidence of POST was monitored at 0, 2, 4, and 24 hours postoperatively. Complications regarding opioids were compared between groups.Results:The overall incidence of POST was higher in the HR group compared with that in the LR group [33 (72%) vs 18 (39%), P = .022]. The incidence of POST at 0, 2, and 24 hours after surgery was higher in the HR group compared with that in the LR group (P < .001, P = .001, and P = .001, respectively). The incidence of postoperative nausea, vomiting, drowsiness, and headache was similar between the groups. The incidence of postoperative shivering was higher in the HR group than in the LR group [10 (22%) vs 2 (4%), difference 17%, 95% CI 2%–33%, P = .027].Conclusion:A relatively large dose of intraoperative remifentanil increased the incidence of POST in patients for orthopedic surgery under general anesthesia.Trial Registration:Clinicaltrials.gov Identifier: NCT03173339.

Inhalation of Ketamine in Different Doses to Decrease the Severity of Postoperative Sore Throat in Surgeries under General Anesthesia Patients.

Context:Postoperative sore throat (POST) occurs in 21%–65% of patients. Nebulization of ketamine reduces POST.Aims:The aim of this study is to see the effectiveness of nebulized ketamine in different doses to reduce POST and observe adverse effects, if any.Settings and Design:This was a prospective, randomized, and double-blind controlled trial. One hundred and fifty patients of the American Society of Anesthesiologists physical status Classes I and II, in the age group of 18–60 years, of either sex, undergoing surgery under general anesthesia were randomized into three groups.Subjects and Methods:Patients had nebulized with 5 ml solution (Group K1 – 1 ml of ketamine [50 mg/ml] +4 ml normal saline, Group K2 – 0.5 ml of ketamine [50 mg/ml] +4.5 normal saline, and Group S – 5 ml normal saline). Preoperative, intraoperative, and postoperative hemodynamic monitoring was done. The POST monitoring was done at 2, 4, 8, 12, and 24 h postoperatively. POST was graded on a four-point scale (0–3).Statistical Analysis Used:Chi-square test using MSTAT software for POST and ANOVA test using INDOSTAT software for hemodynamics were used in this study.Results:The overall incidence of POST in the present study was 29.33% (44/150). In Group S, the incidence of POST was observed to be 46% (23/50). In Group K1, the incidence was 20% (10/50), and in Group K2, it was 22% (11/50) (P ≤ 0.05), and intraoperative vital signs were more stable at all time intervals.Conclusions:We concluded that both doses (25 and 50 mg) of nebulized ketamine were almost equally effective in preventing POST, with no adverse effects.

Preoperative ketamine nebulization attenuates the incidence and severity of postoperative sore throat: A randomized controlled clinical trial.

Background:Endotracheal intubation is the prominent cause of airway mucosal injury which results in postoperative sore throat (POST), with an incidence of 21%–65%. Although this complication is minor, if left unresolved, it produces significant agony and annoyance to the patient. This study was conducted to evaluate the efficacy of nebulized ketamine in decreasing POST.Materials and Methods:After written informed consent, 96 patients of the American Society of Anesthesiologists physical status (PS) 1–2 between 18 and 60 years, of either sex undergoing general anesthesia (GA) with tracheal intubation were enrolled in this prospective, randomized, placebo-control, and double-blind controlled trial. Patients were randomized into two groups; Group 1 received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulization, while Group 2 received saline nebulization 5.0 ml for 15 min. GA was administered 15 min after completing nebulization. On reaching postanesthesia care unit, POST monitoring was done at 0, 2, 4, 6, 12, and 24 h after extubation. POST was graded on a four-point scale (0–3).Results:The overall incidence of POST in this study was 25%: POST was experienced by 7 patients (14.6%) in ketamine and 17 patients (35.4%) in saline group (Fisher's exact P = 0.018). There was statistically significant reduction in the incidence of POST in ketamine group when compared to saline, at 2, 4, 6,12, and 24 h postoperatively (P < 0.05*). Severity of sore throat was also higher in saline group when compared to ketamine at 4 h (P = 0.030*) and 6 h (P = 0.016*) postextubation.Conclusion:Preoperative ketamine nebulization effectively reduced the incidence and severity of POST, with no adverse effects.

Combined intraoperative paracetamol and preoperative dexamethasone reduces postoperative sore throat: a prospective randomized study.

Postoperative sore throat (POST) after general anesthesia with endotracheal intubation is a common and undesirable complication. In this study, we evaluated the combined effects of paracetamol and dexamethasone on the prevention of POST in patients after general anesthesia. A total of 226 patients scheduled for urologic surgery under general anesthesia were randomly assigned to one of two groups. In the DexaPara group (n=113), dexamethasone (10mg) and paracetamol (1000mg) was infused. In the Dexa group (n=113), dexamethasone (10mg) alone was given. POST, hoarseness, and dysphagia were monitored. The postoperative wound pain score and perioperative opioid requirements were compared. In addition, complications related to opioids were compared between the groups. The overall incidence of POST was lower in the DexaPara group than in the Dexa group [42 (37%) vs. 72 (64%), p<0.001]. The incidence of POST while resting at postoperative 1 and 6h was lower in the DexaPara group than in the Dexa group (p=0.008 and p=0.004, respectively). The incidence of postoperative nausea, vomiting, drowsiness, shivering, and headache was comparable between the groups. Paracetamol and dexamethasone infusion reduced the incidence of POST without serious complications in patients for urologic surgery under general anesthesia.

The effect of lidocaine jelly on a taper-shaped cuff of an endotracheal tube on the postoperative sore throat

Background:Postoperative sore throat (POST) following general anesthesia with endotracheal intubation is a common complication. We hypothesized that lidocaine jelly applied to the tapered cuff of the endotracheal tube (ETT) might decrease the incidence of POST most commonly arising from endotracheal intubation.Methods:A total of 208 patients under general anesthesia were randomly assigned into 1 of 2 groups. In the lidocaine group (n = 104), the distal part of ETTs with tapered-shaped cuff was lubricated with lidocaine jelly. In the control group (n = 104), the distal part of ETTs with tapered-shaped cuff was lubricated with normal saline. The incidence of POST, hoarseness, and cough in the postanesthesia patients was compared.Results:The overall incidence of POST was higher in the lidocaine group than in the normal saline group [60 (58%) vs 40 (39%), P = .006]. The incidence of POST at 1 hour postoperatively was higher in the lidocaine group than in the normal saline group [53 (51%) vs 32 (31%), P = .003]. The overall incidence of hoarseness for 24 hours postoperatively was comparable (P = .487). The overall incidence of cough for 24 hours postoperatively is higher in the lidocaine group (P = .045).Conclusion:The lidocaine jelly applied at the distal part of ETT with tapered-shaped cuff increased the overall incidence of POST in patients undergoing general anesthesia.

Comparison of nebulized ketamine and ketamine with clonidine in postoperative sore throat

Background: Postoperative sore throat (POST) consider a minor ailment in patients receiving general anesthesia with endotracheal intubation, seen in 21-65% cases but it causes significant distress and increases postoperative morbidity and patient dissatisfaction. This study was done to compare nebulized ketamine and ketamine with clonidine to treat POST.Methods: This was a prospective, randomized, double-blind control clinical study. After approval from institution ethical and scientific committee, study was conducted in between May 2015-April 2016. Written and informed consent was obtained from 100 patients of either sex aged between 20-65 years. ASA I-II, undergoing surgery in supine position lasting up to two hour. Patients were randomized into two groups Group K (n=50) nebulized with 50 mg ketamine (1cc) + 3cc NS =4cc, Group KC (n=50) nebulized with ketamine 50mg (1cc) + clonidine 150µg (1cc) + 2cc NS for 15 min, before general anaesthesia with endotracheal intubation. The POST and hemodynamic variable were monitored before nebulization, after nebulization, before induction, on arrival to PACU and at 4, 8, 12, 24 hours post operatively. POST was graded on 4 point scale (0-3).Results: Overall incidence of POST was 46% (Group K-40%, KC-6%). The Incidence and severity of POST were significantly attenuated in Group KC in comparison to Group K at 4 hours (P= 0.002), 8 hours (P=0.000), 12 hours (P= 0.000) and at 24 hours (P=0.000).Conclusions: Preoperative nebulization with clonidine and ketamine mixture compared to ketamine is more effective in dealing with postoperative sore throat with no adverse effects.

Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients

ObjectiveTo investigate the incidence of postoperative sore throat (POST) in Korean patients undergoing general anaesthesia with endotracheal intubation and to assess potential risk factors.MethodsThis prospective study enrolled patients who underwent all types of elective surgical procedures with endotracheal intubation and general anaesthesia. The patients were categorized into group S (those with a POST) or group N (those without a POST). The demographic, clinical and anaesthetic characteristics of each group were compared.ResultsThis study enrolled 207 patients and the overall incidence of POST was 57.5% (n = 119). Univariate analysis revealed that significantly more patients in group S had a cough at emergence and hoarseness in the postanaesthetic care unit compared with group N. Receiver operating characteristic curve analysis showed that an intracuff pressure ≥17 cmH2O was associated with POST. Multivariate analysis identified an intracuff pressure ≥17 cmH2O and cough at emergence as risk factors for POST. At emergence, as the intracuff pressure over ≥17 cmH2O increased, the incidence of hoarseness increased.ConclusionsAn intracuff pressure ≥17 cmH2O and a cough at emergence were risk factors for POST in Korean patients. Intracuff monitoring during anaesthesia and a smooth emergence are needed to prevent POST.

Nebulized ketamine decreases incidence and severity of post-operative sore throat.

Background and Aims:Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST.Methods:We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3).Results:The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02).Conclusion:Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects.

Comparison of postoperative sore throat following laryngoscopy conducted by Miller and Macintosh laryngoscope blades

BACKGROUND: Post operative sore throat (PST) is one of the most common complaints after tracheal intubation. In this study we compared the effects of curved and straight laryngoscope blades on severity and incidence of PST. METHOD: In this prospective randomized clinical trial we evaluated incidence and severity of PST in 147 ASA physical status I–II, aged 18 – 62 y (group Miller, n = 71), (group Macintosh, n = 76) following intubation with Miller and Macintosh laryngoscope blades by using Visual Analog Scale (VAS). RESULTS: The overall incidence of PST in our study was 35.4% (Macintosh group = 39.5% and in Miller group = 31% and P = 0.829). The incidence of PST was not statistically different between two kinds of laryngoscope blades and the mean rank of pain score was not statistically different in recovery room and up to 48 hours after surgery. CONCLUSIONS: Our study showed these types of laryngoscope blade had not association with incidence and severity of PST. .