Postoperative Sore Throat Research Articles

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).

Effect of a 3D-printed reconstruction automated matching system for selecting the size of a left double-lumen tube: a study protocol for a prospective randomised controlled trial

IntroductionLung isolation is primarily accomplished using a double-lumen tube (DLT) or bronchial blocker. A precise and accurate size of the DLT is a prerequisite for ensuring its accurate placement. Three-dimensional...

Individualized rotation of left double lumen endobronchial tube to improve placement success rate: a randomized controlled trial

BackgroundIn conventional practice, the left double lumen tube (DLT) is rotated 90° counterclockwise when the endobronchial cuff passes glottis. Success rate upon the first attempt is < 80%, likely owing to varying morphology of the bronchial bifurcation.MethodsWe conducted a randomized controlled trial to compare 90° counterclockwise rotation versus individualized degree of rotation in adult patients undergoing elective thoracic surgery using left DLT. The degree of rotation in the individualized group was based on the angle of the left main bronchi as measured on computed tomography (CT). The primary outcome was the first attempt left DLT placement success rate.ResultsA total of 556 patients were enrolled: 276 in the control group and 280 in the individualized group. The average angle of the left main bronchi was 100.6±9.5° (range 72° to 119°). The first attempt left DLT placement success rate was 82.6% (228/276) in the control group versus 91.4% (256/280) in the individualized group (P=0.02, χ2 test). The rate of carina mucosal injury, as measured at 30 min after the start of surgery under fibreoptic bronchoscopy, was significantly lower in individualized group than control group (14.0% versus 19.6%, P=0.041). The individualized group also had lower rate of postoperative sore throat (29.4% versus 44.0%, P<0.001) and hoarseness (16.8% versus 24.7%, P＜0.05).ConclusionsIndividualized rotation of left DLT based on the angle of the left main bronchi on preoperative CT increased first attempt success rate in adult patients undergoing elective thoracic surgery.Trial registrationThe trial is registered at Chinese Clinical Trial Registry (ChiCTR2100053349; principal investigator Xiang Quan, date of registration November 19, 2021).

Does salivary pH affect postoperative sore throat in the head-down position of general anesthesia?

Tracheal intubation sometimes causes postoperative sore throat (POST) due to laryngeal damage. However, clinical observations suggest that the environment of the oral cavity may also affect POST. The purpose of this study was to investigate whether salivary pH in the oral cavity affects POST. After obtaining ethical approval, informed consent was obtained from all patients. Patients who underwent surgery in the supine position were enrolled as the control group. Patients who underwent laparoscopic surgery in the head-down position were enrolled as the intervention group. Immediately before both groups of patients were anaesthetised, expelled saliva was collected, and salivary pH was measured. Immediately postoperatively, the same measurement was carried out before the patient regained consciousness. The primary outcome was the change in salivary pH. The secondary outcome was POST. In our study, POST was defined as pharyngeal and swallowing pain in the glossopharyngeal and superior laryngeal nerves. The normal distribution of pH was tested using the Shapiro-Wilk test followed by analysis using repeated-measurements and one-way analysis of variance. Statistical significance was set at p < .05. A total of 62 patients were enrolled, of whom two were excluded based on the exclusion criteria. Salivary pH in the intervention group was significantly lower than that in the control group. Five patients had POST in the intervention group, whereas none had POST in the control group had POST. Acidotic-shifted saliva is considered one of the causes of POST.

Comparative evaluation of self-pressurized Air-Q® and Proseal™ LMA® in patients undergoing elective surgery under general anaesthesia: A randomized clinical trial.

Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.

The effect of different endotracheal tube cuff pressure monitoring systems on postoperative sore throat in patients undergoing tracheal intubation: a randomized clinical trial

BackgroundPostoperative sore throat (POST) is an unpleasant outcome that can occur as a result of tracheal intubation in adults. Increased pressure from the endotracheal tube (ETT) cuff often leads to local mucosal injury, resulting in sore throat. The purpose of this study was to compare the effect of two different ETT cuff pressure monitoring systems vs. no cuff pressure monitoring on the incidence and severity of POST in adults.MethodsOne hundred and fourteen ASA I-III patients of either gender, aged 18–65 years, and undergoing surgery requiring endotracheal intubation were included in this study. Patients were randomized into three groups: control (C), cuff pressure gauge (G), and automated cuff controller (A). The ETT cuff pressure was not monitored intraoperatively in group C but was monitored using a cuff pressure gauge and an automated cuff controller in groups G and A, respectively. Postoperatively, patients were assessed at 2, 24, and 48 h for the presence and severity of POST, hoarseness and cough.ResultsOne hundred and eleven patients completed the study. POST occurred in 40.5% of the patients in group G (n = 37) (p = 0.013) and 23.7% of the patients in group A (n = 38) (p < 0.001) within 48 h after surgery, compared to 69.4% in group C (n = 36). There were no significant differences in hoarseness, coughing, and dysphagia across the groups at any time. When comparing groups A and C, individuals in group A exhibited a lower occurrence of significant (grade ≥ 2) POST and hoarseness (10.5% vs. 41.7%, p = 0.002; 26.3% vs. 58.3%, p = 0.005). The incidence of significant cough and dysphagia did not differ substantially across the patient groups within 48 h after surgery. POST scores in group A at 2, 24 h postoperatively were both 0 (0–0), which was significantly lower than those in group C (1 (0–2) at 2 h, p < 0.001 ; 1 (0–1) at 24 h, p = 0.001). POST in group G at 2 h postoperatively was graded as 0 (0–1.5) which was milder than group C (P = 0.024). The severity of hoarseness in group A with scores of 0 (0–2) was superior to that in group C (2 (0–2), p = 0.006) at 2 h postoperatively.ConclusionsIn conclusion, the findings of this study indicated that the occurrence of POST can be reduced by using either the cuff pressure gauge approach or the automated cuff controller method. The automated cuff controller monitoring can potentially decrease the severity of POST and hoarseness.Trial registrationChinese Clinical Trial Registry, identifier: ChiCTR2100054089, Date: 08/12/2021.

The effect of the endotracheal tube cuff shape on post-operative sore throat in surgeries longer than 120 min in supine position

The effect of the endotracheal tube cuff shape on post-operative sore throat in surgeries longer than 120 min in supine position

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

Non-pharmacological Methods in the Management of Postoperative Sore Throat in Patients Undergoing Endotracheal Intubation: A Systematic Review

Non-pharmacological Methods in the Management of Postoperative Sore Throat in Patients Undergoing Endotracheal Intubation: A Systematic Review

Editöre Mektup: Postoperatif Boğaz Ağrısı ve Bulantı-Kusma Hakkında

Editöre Mektup: Postoperatif Boğaz Ağrısı ve Bulantı-Kusma Hakkında

The Effects of Budesonide Nebulization on Post-operative Sore Throat After General Anaesthesia

Post-operative sore throat after general anaesthesia with endo-tracheal intubation occurs in 21% to 65% of patients.1 It has been reported to be one of the most undesirable outcomes in the post-operative period influencing patient satisfaction.2 Complaints range from minor throat irritation to debilitating pain, inability to swallow and temporary hoarseness of voice. Routine tracheal intubation for surgical procedures can result in pathological changes, trauma and nerve damage which may cause post operative sore throat. Several non-pharmacological methods like small sized endotracheal tubes,3 lubricating the endotracheal intubation tube with water soluble jelly, intubation after full relaxation, minimizing intra-cuff pressure and extubation when cuff is fully deflated, the pharmacological measures include gargling and nebulization with drugs like budesonide, beclomethasone, ketamine, lignocaine etc., have been studied.4,5 Budesonide is a non-halogenated glucocorticoid with powerful anti-inflammatory effects. It relieves congestion, reduces capillary permeability and oedema in the laryngeal mucosa. It is the only corticosteroid approved by FDA that can be used for aerosol inhalation.5 There are no studies on Indian population to evaluate the efficacy of budesonide on post-operative sore-throat. We found that Budesonide nebulization in a dose of 1 mg, 15 minutes before endotracheal intubation reduced the incidence and severity of sore-throat, cough and hoarseness of voice in the post-operative period up to 24 hrs in patients who underwent elective middle ear surgery under general anaesthesia. There were no systemic side effects with budesonide nebulization and patient satisfaction was good.

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, 134:3437-3446, 2024.

Endotracheal Tube Cuff Pressures and Incidence of Postoperative Sore Throat

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

COMPARATIVE EVALUATION OF INCIDENCE, SEVERITY, AND RELATION OF SORE THROAT AFTER ENDOTRACHEAL INTUBATION AT DIFFERENT CUFF PRESSURES

Objective: The primary objective of the study was to evaluate and compare the incidence, severity, and relation of sore throat after endotracheal intubation at different cuff pressures. The secondary objective of the present study was to evaluate whether regular monitoring of cuff pressure has any additional advantage during surgical procedures. Methods: Study design – A prospective, comparative, and randomized study. Group A – 25 female patients of age 20–35 where cuff pressure was kept at 15 cm H2O. Group B – 25 female patients of age 20–35 where cuff pressure was kept at 20 cm H2O. Group C – 25 female patients of age 20–35 where cuff pressure was kept at 25 cm H2O. Group D – 25 female patients of age 20–35 where cuff pressure was kept at 30 cm H2O. The patient was visited at 24 h, 48 h, and 72 h following extubation and enquired about the incidence of sore throat. Results: The incidence and severity of sore throat ranged from as low as 16% in group A to as high as 60% in group D at 24 h. Groups B and C showed incidences of 28% and 40%, respectively. The incidence of sore throat was found to be 12% in group A to as high as 40% in group D at 48 h postoperatively, which was further decreased to just one patient with a scratchy feeling in group A and three patients in group D at 72 h with incidence ranging from 4% to 12% only. Conclusion: As the cuff pressure goes on increasing, the incidence and severity of sore throat also increase, and cuff pressure should be monitored and regulated continuously. Moreover, the cuff pressure should not exceed 25 cm of H2O to minimize post-operative sore throat.

Use of K-Y Jelly on Throat Packs for Postoperative Sore Throat after Nasal Surgery: A Randomized Controlled Trial.

Introduction Postoperative sore throat (POST) is a fairly common side effect of general anesthesia. The K-Y jelly is a well-known lubricant used in many medical procedures. Objective In this randomized study, we evaluated the use of throat packs soaked with K-Y jelly for POST outcomes in patients submitted to nasal surgery. Methods The present double-blinded, randomized, controlled study included 140 ASA I-II patients undergoing nasal surgery under general anesthesia. Patients received either or K-Y jelly or water-soaked X-ray detectable throat packs fully inserted into the mouth to occlude the oropharynx. Results Comparison between the studied groups regarding the severity of POST assessed by visual analog scale revealed significantly lower POST levels in the K-Y jelly group on recovery from anesthesia, and at 2, 4, and 6 hours postoperatively. Conclusions The use of K-Y jelly-soaked throat packs was associated with less severe POST after nasal surgery.

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.

Intravenous versus intracuff alkalinized lidocaine to prevent postoperative sore throat: a prospective randomized controlled trial.

postoperative sore throat (POST) is a common complication after general anesthesia with endotracheal intubation caused by tracheal mucosal injury. Multiple techniques prevent postoperative sore throat (POST). Our study aimed to compare two techniques: intravenous and intracuff lidocaine versus placebo to prevent postoperative sore throat after general anesthesia with orotracheal intubation. we conducted a prospective double-blind, randomized controlled clinical trial involving patients, proposed for a scheduled surgery less than 240 minutes under general anesthesia with orotracheal intubation. Patients were divided into three groups: L group: infused with saline, cuff filled with alkalinized lidocaine. S group: Infused with 1.5 mg/kg of lidocaine, cuff filled with saline. T group: placebo: infused with saline, cuff filled with saline. Our primary outcome was the incidence of sore throat and their (visual analog scale) VAS score in the first 24 postoperative hours. Our secondary outcomes were the incidence of cough, dysphonia, dysphagia, and postoperative nausea and vomiting. ninety patients were analyzed and divided into 3 groups of 30. The incidence of POST at the sixth postoperative hour, for placebo, the "L" group, and the "S" group, respectively, was 67%, 30%, and 47%. And at the 24th postoperative hours 67%, 13%, and 37%. Intravenous lidocaine reduced significantly the VAS of POST at the 24th hour (S: 6.80 ± 20.70; T: 20.67 ± 18.182; p= 0.02). Alkalinized lidocaine decreased significantly the VAS of POST in the sixth (L: 8.17 ± 22.761; T: 23 ± 21.838; p = 0.048) and the 24th postoperative hour (L: 6.33 ± 20.592; T: 20.67 ± 18.182; p= 0.019) with the lowest pain score. There was no statistically significant difference between the L and S groups at the 6 and 24 postoperative hours. Both lidocaine techniques reduced cough at emergence, with the superiority of alkalinized lidocaine (p=0.02). They decreased the incidence of cough, dysphonia, dysphagia, nausea, and vomiting compared to a placebo. intravenous and intracuff lidocaine allowed better control of postoperative sore throat.

Comparison of BPL™ Video Laryngoscope and Macintosh Laryngoscope Guided Throat Packing for Head and Neck Surgeries: A Randomised Controlled Study

Introduction: Evidence regarding throat packing for head and neck surgeries is limited. A video laryngoscope, an airway adjunct used for various diagnostic and therapeutic purposes, can also effectively pack the throat. Aim: To compare the Time Taken for Throat Packing (TTTP) using a non-channeled video laryngoscope BPL™ versus the conventional Macintosh larynogoscope direct laryngoscope. Materials and Methods: In this non-inferiority, randomised controlled, single-blind study, 72 patients undergoing head and neck surgeries requiring throat packing were recruited. The non-inferiority margin was set at 10 seconds between the two groups (n=36 each). Throat packing in Group-M and Group-V was performed using the Macintosh and video laryngoscopes with the assistance of Magill’s forceps. The TTTP was recorded from the blade insertion to complete blade removal. A one-sided two-sample unpaired t-test was used to test non-inferiority hypothesis considered in this study. Results: The mean age of patients in Group-M was 37.39 years and in Group-V was 33.65 years, with mean weights of 60.89 kg and 56.32 kg, respectively. The mean TTTP difference between Group-M and Group-V was found to be -12.6 seconds with a lower limit of the one-sided 95% Confidence Interval (CI) of −20.6s. The null hypothesis was accepted, concluding that video laryngoscope-guided throat packing took a longer duration. The ease of throat packing, haemodynamic stress response, and Postoperative Sore Throat (POST) were comparable between both groups. Conclusion: Video laryngoscope-guided throat packing is inferior to conventional Macintosh throat packing in terms of TTTP. However, it is equivocal regarding the ease of throat packing and the stress response induced. POST was the same whether throat packing was performed using a video laryngoscope or a Macintosh laryngoscope.