Prevention Of Postoperative Sore Throat Research Articles

Comparison of adding magnesium sulfate, dexmedetomidine and ondansetron to lidocaine for gargling before laryngoscopy and endotracheal intubation to prevent sore throat: a randomized clinical trial.

Postoperative sore throat is one well-recognized complication, occurring most frequently following tracheal intubation. Effective prevention of postoperative sore throat has been recognized as a top priority, bringing pleasant feelings and satisfaction to patients. This study aimed to assess the efficacy of magnesium sulfate, dexmedetomidine and ondansetron gargle with lidocaine administrated prior to laryngoscopy and tracheal intubation for postoperative sore throat prevention alongside hemodynamic management. This double-blind randomized clinical trial enrolled 105 general anesthesia-administered patients who had undergone laryngoscopy and endotracheal intubation, and they were equally randomized into three groups: magnesium sulfate, dexmedetomidine, and ondansetron groups. No significant intergroup difference was seen in oxygen saturation, non-invasive blood pressure, heart rate, duration of surgery, postoperative complications, analgesic consumption, and incidence of cough and hoarseness. The results showed statistically significant intergroup differences in pain scores and average pain intensity in the dexmedetomidine group was significantly lower than the other groups. Results suggest that dexmedetomidine gargle with lidocaine before general anesthesia induction could be recommended as an option depending on the patient's general condition and the anesthesiologist's discretion.

Is it Safe to Use Ultrasound-Guided Superior Laryngeal Nerve Block for the Prevention of Postoperative Sore Throat After Double Lumen Endotracheal Intubation?

Is it Safe to Use Ultrasound-Guided Superior Laryngeal Nerve Block for the Prevention of Postoperative Sore Throat After Double Lumen Endotracheal Intubation?

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

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

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.

Comparative study of magnesium sulphate nebulization and lignocaine nebulization in prevention of postoperative sore throat (POST)

Background: General anaesthesia (GA) includes intubation a necessary step to provide adequate ventilation in patients under anaesthesia along with protection of airway from regurgitation and aspiration. Postoperative sore throat (POST), hoarseness of voice, cough are common sequelae. The present study compares the efficiency of preoperative nebulization of lignocaine hydrochloride and magnesium sulphate for reducing the incidence of POST in patients under GA. Methods: The study conducted in GMC Kota and attached hospitals on 100 patients of surgery duration one hour to three hours. Patients were randomly allocated in two groups Lignocaine group and Magnesium group. Results: The majority of patients belonged to the age between 40 and 70 years. There was no significant difference in the mean pulse rate, SBP, mean SpO2. Comparison of sore throat in both the groups at rest, just after extubation, 2 hours, 8 hours, 24 hours and 48 hours showed incidence more common in lignocaine group than magnesium group but no significant difference (P&gt;0.05). Hoarsness after extubation reduced within 24 hours in Magnesium group in comparison to Lignocaine group where it persists till 48 hrs. Conclusion: Incidence of sore throat, hoarseness of voice and cough was more common in lignocaine group and more in female patients. Both drugs can be used for prevention of postoperative sore throat, but magnesium sulphate has better results.

Comparison of Nebulized Ketamine with Nebulized Magnesium Sulfate for the Prevention of Postoperative Sore Throat

Objective: To compare the effects of nebulized Ketamine versus nebulized Magnesium Sulfate to prevent post-operative sore throat.&#x0D; Study Design: Quasi-Experimental Study.&#x0D; Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Sep 2020 to Feb 2021.&#x0D; Methodology: A total of 154 patients who underwent general anaesthesia for elective procedures were randomly included in the study. These patients were divided into two equal Groups, i.e., Group-A (n=77), who received Magnesium Sulphate 250mg in 5ml saline and Group-B (n=77), who received Ketamine 50mg in 5ml saline, respectively. The effects of nebulized Ketamine versus nebulized Magnesium Sulfate to prevent post-operative sore throat, were observed in both the Groups.&#x0D; Results: Both drugs were effective in the prevention of sore throat after extubation. Our study showed that Ketamine nebulization was more effective than Magnesium Sulfate nebulization in preventing sore throat. The frequency of sore throat in Group-A was 54.5% (42 out of 77 patients) as compared to 31.2% (24 out of 77 patients) in Group-B, which was statistically significant (p=0.003).&#x0D; Conclusion: Post-operative sore throat is more effectively controlled with Ketamine as compared to Magnesium Sulfate

The effectiveness of acupuncture point stimulation for the prevention of postoperative sore throat: A meta-analysis.

Enhanced recovery pathways can be further improved for postoperative sore throat (POST) that occurs after surgery under general anesthesia. Medications have shown some effectiveness in preventing POST, but acupuncture or related techniques with better safety and lower cost can be used as an alternative or adjuvant therapy to treat perioperative symptoms by stimulating acupuncture point (acupoint). Therefore, we aimed to conduct a meta-analysis to assess whether acupoint stimulation helps patients prevent POST in adults undergoing tracheal intubation for general anesthesia. Publications in PubMed, the Cochrane Central Register, ScienceDirect, and ClinicalTrial.gov were surveyed from January 2000 through August 2020. Studies that compared interventions between true acupoint stimulation and no or sham acupoint stimulation were included. The primary outcomes were the incidence and severity of POST at 24h. Four randomized control trials and 1 comparative study involving 1478 participants were included. Compared with the no or sham acupoint stimulation, the true acupoint stimulation was associated with a reduced incidence (risk ratio, 0.32; 95% confidence interval (CI), 0.18-0.55; P < .001) and decreased severity (standardized mean difference, -2.79; 95% CI, -4.59 to - 0.99; P = .002) of POST. There were no significant adverse events related to acupoint stimulation. The finding for POST was assured by subgroup, sensitivity, and trial sequential analyses. Acupoint stimulation may reduce the occurrence of POST. It can be considered as one of nonpharmacological methods to prevent POST in enhanced recovery pathways. Further rigorous studies are needed to determine the effectiveness of acupoint stimulation.

Implementation of Evidence in Preventing Postoperative Sore Throat of Patients Undergoing General Anesthesia Intubation Using the i-PARIHS Framework.

Objective The aim of the study was to assess the effectiveness of the implementation of the best evidence in preventing postoperative sore throat in patients undergoing general anesthesia intubation. Methods The related topics of the postoperative sore throat of patients undergoing general anesthesia intubation were systematically searched in the database and evaluated using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Combined with clinical needs and evidence-based professional judgment, 20 pieces of evidence and 6 examination standards on the management process and evidence implementation plan for the prevention of postoperative sore throat in patients with general anesthesia intubation are summarized, implementing the best evidence into clinical practice in anesthesiology, general surgery, orthopedics, thoracic surgery, and gynecology. Results Nurses' knowledge scores and evidence compliance significantly improved after the implementation of the best evidence (P < 0.05); the incidence of the postoperative sore throat in patients undergoing general anesthesia intubation decreased from 41.7% to 28.1%. Conclusion The i-PARIHS framework effectively prevents postoperative sore throat in patients, providing an effective case for translating evidence into practice based on the i-PARIHS framework.

Comparative evaluation of incidence of post operative sore throat after nebulization with ketamine and magnesium sulfate in patients undergoing general anaesthesia requiring endotracheal intubation

Post-operative pharyngeal discomfort or sore throat is unavoidable outcome of endotracheal intubation. There are some pharmacological and non-pharmacological methods for prevention of postoperative sore throat. Nebulization is better than gargle or other methods as small volume of drug required for effect, easy way of administration, better patient compliance and most importantly no risk of aspiration as seen with gargle. In our study, 88 patients of ASA grading I- Ⅲ, aged between 18-65 years undergoing general anaesthesia on elective basis were randomly divided into two groups. 44 patients received pre-operative nebulization with 1ml ketamine(50mg) with 1ml normal saline while others received nebulization with 500mg Magnesium sulfate with 1ml normal saline. General anaesthesia was given. Number of intubation attempts, duration of laryngoscopy and duration of surgery were recorded. Patients were evaluated for post-operative sore throat, hoarseness of voice and cough at 0hr, 2hr, 4hr, 12hr, and 24hr in postoperative period. Incidence of post-operative sore throat, cough and hoarseness of voice was reduced statistically significantly with ketamine nebulization when compared to magnesium sulphate nebulization (p=&amp;#60;0.05). There were no systemic side effects with any drug. Ketamine nebulization was superior than magnesium nebulization in prevention of sore throat.

Effects of Thermal Softening of Double-Lumen Endobronchial Tubes on the Prevention of Postoperative Sore Throat in Smokers: A Randomized Controlled Trial

Tracheal intubation-related complications, such as postoperative sore throat (POST), hoarseness, and vocal cords injuries, are not uncommon. It is well known that thermal softening of double-lumen endobronchial tubes (DLTs) has been used to prevent these events from happening in non-smokers; however, no study has ever assessed the effects of thermal softening of DLTs in smokers undergoing one-lung anesthesia. The authors aimed to investigate whether thermal softening of DLT can achieve a better effect in preventing POST. A total of 258 smokers scheduled for one-lung anesthesia were randomly assigned to 1 of the following 2 groups: (1) group C (non-thermal softening group) and (2) group T (DLTs were placed in 40°C 0.9% saline for 10 minutes). Incidence and severity of POST and hoarseness were assessed until 48 hours after surgery. Vocal cords were examined using laryngoscope before intubation and immediately after extubation. Patients' hemodynamic change at intubation and extubation was recorded. The primary outcomes were the incidence and severity of POST. The secondary outcomes were the incidence and severity of hoarseness, vocal cords injuries, and patients' hemodynamic change at intubation and extubation. Sore throat and vocal cord injuries occurred less frequently in the thermal softening group than in the control group (31/129 v 60/129, p < 0.01; 21/129 v 49/129, p < 0.001; 12/129 v 35/129, p < 0.001 for sore throat; 14/70 v 27/70, risk ratio (95% confidence interval): 0.52 (0.30-0.90), p=0.025 for sore throat; 5/129 v 52/129, p < 0.05 for vocal cord injuries). Thermal softening of DLTs significantly reduced the incidence and severity of DLTs intubation-related POST within 72 hours after extubation.

Effectiveness of Ketamine Gargles in Prevention of Post-Operative Sore Throat in Patients Undergoing Endotracheal Intubation

Objective: To compare the efficacy of ketamine gargles versus placebo in prevention of post-operative sore throat in patients undergoing endotracheal intubation. Study design: Randomized controlled trial. Place and Duration of Study: Department of Anesthesiology and Critical Care, National Institute of Cardiovascular Diseases, Karachi from 13th April 2018 to 12th October 2018. Methodology: Eighty six patients undergoing elective pelvic or abdominal surgery under general anaesthesia of age between 18–50 years of either gender were included. Patients with preoperative sore throat in addition to asthma who require more than single attempt for tracheal-tube passage were excluded from the study. Patients were allocated into two groups (Group K and Group P). All patients were premedicated with alprazolam 0.25 mg orally 3 hours before surgery. Patients in group K was given preservative free ketamine 1 ml (50 mg) in 29 ml of drinking water whereas group P was given 30 ml drinking water on entering the operation theater and was asked to gargle with the preparation for 40 seconds. At the end of 24 hours of surgery patients were asked to mark the severity of POST pain on the scale. A score of 0-3 was considered as effectiveness. Results: The mean age of women in group K was 38.58±7.57 years and in group P was 38.21±7.33 years. Fifty nine (68.60%) were males and 27 (31.40%) were females. The efficacy (in terms of prevention of postoperative sore throat) was seen in 36 (83.72%) patients in group K (ketamine gargles) and in 22 (51.16%) patients in group P (placebo) with p-value of 0.001. Conclusion: Ketamine gargle is very effective in prevention of post-operative sore throat in patients undergoing endotracheal intubation. Keywords: Endotracheal intubation, Ketamine gargles, Post-operative sore throat

A Comparative Evaluation of the Effect of Preoperative Ketamine and Tramadol Nebulisation on Post Operative Sore Throat after Endotracheal Intubation

Background: Postoperative sore throat (POST) is a common complaint during postoperative period after tracheal intubation. We evaluated and compared the effects of preoperative ketamine or tramadol nebulization on POST in patients undergoing general anaesthesia with tracheal intubation. Methods: Sixty patients, aged 18-60 years of ASA status 1 &amp; 2 scheduled for elective surgery lasting upto 2 hours under general anaesthesia with endotracheal intubation were randomly divided into two groups; Group K: patients received Ketamine 50 mg (1 ml) with normal saline (4 ml) nebulisation, Group T: patients received Tramadol 50 mg (1 ml) with normal saline (4 ml) nebulization 30 min before induction. Incidence of postoperative sore throat and its intensity, nausea vomiting, sedation and any side effects of drugs were recorded. Result: No significant difference was observed in the incidence of postoperative sore throat between the ketamine group and tramadol group patients. Severity of POST was higher in group T as compared to group K but it was statistically insignificant. Nausea, vomiting and sedation incidence was comparable in both groups. Conclusion: Preoperative nebulisation with ketamine is clinically more effective than tramadol nebulization in prevention of postoperative sore throat.

Evaluation of the Efficacy of Turmeric-Based Lozenges for the Prevention of Postoperative Sore Throat in Surgeries Done Under Laryngeal Mask Airway Insertion.

Sore throat is a common complaint to both laryngeal mask airway (LMA) insertion and endotracheal tube intubation. Its incidence in LMA has been found to vary between 5.8% and 34%. Administration of medicated lozenges in the preoperative period is also a route available for the prevention of postoperative sore throat (POST). The aim of this double-blinded randomized controlled study was to evaluate the efficacy of turmeric-based lozenges given preoperatively in patients undergoing general anesthesia (GA) under LMA insertion for the prevention of POST. This study was conducted at the Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Rama Nagar, Dehradun, over a period of 12 months. Two hundred and fifty patients of the American Society of Anesthesiologists classes I and II posted for elective surgeries under GA with insertion of LMA were included in our study. Randomization was done by the sealed envelope technique. Turmeric extract with menthol and eucalyptus oil lozenges was given in Group A (n = 125), while plain turmeric extract with orange flavor lozenges was given in Group B (n = 125) 30 min preoperatively. The patients were assessed for POST in the recovery room post-LMA removal at 30 min, 6 h, 12 h, and 24 h. The data were analyzed using Chi-square test, Fisher's exact test, and Student's t-test. P < 0.05 was considered statistically significant. The turmeric lozenges containing 6.4 mg eucalyptus oil and 6.3 mg menthol oil along with turmeric extract 100 mg significantly reduced the incidence of POST across all time intervals (P < 0.05) as compared to orange-flavored plain turmeric lozenges containing turmeric extract 100 mg. POST was reduced with preoperatively administered eucalyptus oil and menthol oil containing turmeric lozenges.

Comparison of the incidence of postoperative sore throat between patients undergoing videolaryngoscope-guided versus Macintosh laryngoscope-guided double-lumen intubation: a systematic review and meta-analysis

Postoperative sore throat is a common complication of tracheal intubation, especially double-lumen tube intubation, after general anesthesia. Several studies have been conducted to compare the incidence of postoperative sore throat among patients un-dergoing videolaryngoscope-guided double-lumen intubation with that among patients undergoing Macintosh laryngoscope-guided double-lumen intubation. We purported to summarize all the existing evidences to explore the effect of videolaryngoscope and Macintosh laryngoscope on postoperative sore throat in patients with double-lumen intubation. PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were searched for all randomized controlled trials published before 01 June 2021 that compared videolaryngoscopy with Macintosh laryngoscopy for prevention of postoperative sore throat among patients undergoing double-lumen intubation. The results showed that, 9 studies involving 695 patients were included in our meta-analysis. There was no significant difference about the incidence of postoperative hoarseness (risk ratio: 0.80; 95% confidence interval: 0.49–1.32; p-value = 0.38; I2 = 83%), tube malposition (risk ratio: 0.75; 95% confidence interval: 0.07–7.60; p-value = 0.80; I2 = 71%) and the success rate at the first attempt (risk ratio: 1.03; 95% confidence interval: 0.96–1.10; p-value = 0.42; I2 = 70%) between the two groups. We found that the videolaryngoscopy provided much lower incidence of oral injury (risk ratio: 0.49; 95% confidence interval: 0.27–0.89; p-value = 0.02; I2 = 7%) compared with Macintosh laryngoscopy. There was no significant difference in the incidence of postoperative sore throat (risk ratio: 0.74; 95% confidence interval: 0.42–1.32; p-value = 0.31; I2 = 87%) between the two groups. The sensitivity analysis excluding one study suggested that the incidence of postoperative sore throat was lower in the videolaryngoscopy group (risk ratio: 0.64; 95% confidence interval: 0.46–0.89; p-value = 0.008; I2 = 19%). The subgroup analysis suggested that the incidence of postoperative sore throat was lower in the videolaryngoscopy group in studies performed by experienced anesthetists (risk ratio: 0.62; 95% confidence interval: 0.45–0.87; p-value = 0.005; I2 = 5%). The current evidence demonstrates that, experienced anesthetist under the guidance of videolaryngoscope can significantly reduce the risk of postoperative sore throat in patients with double-lumen intubation. Using the videolaryngoscope resulted in a lower incidence of oral injury-related complications. However, there was no advantage in using a videolaryngoscope over Macintosh laryngoscope in the reduction of postoperative hoarseness, tube malposition and the success rate at first attempt.

Postoperative sore throat prevention: Is there an evidence or is it much ado about nothing?

Postoperative sore throat prevention: Is there an evidence or is it much ado about nothing?

Efficacy of perioperative intravenous dexmedetomidine administration for the prevention of postoperative sore throat: a meta-analysis.

ObjectivePostoperative sore throat (POST) is an undesirable intubation-related complication after surgery. Several studies have investigated the efficacy of perioperative intravenous dexmedetomidine administration for the prevention of POST, but the results have been inconsistent. We aimed to summarize all existing evidence and draw a more precise conclusion to guide future clinical work.MethodsPubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were comprehensively searched for all randomized controlled trials published before 1 February 2021 that investigated the efficacy of dexmedetomidine for the prevention of POST.ResultsNine studies involving 400 patients were included in our meta-analysis. Compared with the control groups (i.e., saline and anesthetic drugs), perioperative intravenous use of dexmedetomidine significantly reduced the incidence of POST [risk ratio (RR): 0.56; 95% confidence interval (CI): 0.40–0.77; I2 = 0%) and coughing on the tube during extubation (RR: 0.58; 95% CI: 0.41–0.82; I2 = 0%). Additionally, patients in the dexmedetomidine group were more likely to develop bradycardia (RR: 2.46; 95% CI: 1.28–4.71; I2 = 0%) and hypotension (RR: 3.26; 95% CI: 1.14–9.33; I2 = 0%) during the administration of dexmedetomidine than those in the control group.ConclusionPerioperative intravenous administration of dexmedetomidine has a positive effect on the prevention of POST.

Comparative Study of Magnesium Sulphate and Lignocaine Viscous Gargle in Prevention of Postoperative Sore Throat – A Experimental Study

Background: Postoperative sore throat (POST) is a common occurrence following endotracheal intubation in general anaesthesia Pharmacological agents like local anaesthestics, corticosteroids, ketamine, magnesium sulphate(MgSO4) are tried for attenuating POST. In this study, we compared efficacy of magnesium sulphate with lignocaine gargle on attenuating incidence and severity of POST. Methods: In this randomized double blind controlled study, total 60 adult patients were randomly allocated to two equal groups, Group M (n~30) and group L(n~30). In group M patients received Magnesium sulphate 20mg/kg, dissolved in 20 ml of 5% dextrose solution. In group L patients received 20ml of 2% lignocaine viscous solution. Patients were allowed to gargle slowly for 30 s, 15 min before induction of anesthesia with the solution as per allotment of the group. In post operative period patients were assessed for POST in a four-point scale (0- 3) at 0, 1, 2, 4, 8, 12, and 24 hrs.). Heart rates (HR), SpO2, mean arterial pressure (MAP), were recorded. Results: Incidence of POST in group M recorded lower than group L, and they are 26% vs. 56%, 16% vs. 46%, 10% vs. 40%, 6.6% vs. 33% 3% vs. 20% at 0,1,2,4,8 hrs respectively. Severity of POST was lower in Group M compared to Group L at 0,1,2,4 and 8 hrs. Hemodynamic variables were comparable and statistically insignificant. Conclusion: We suggest the use of MgSO4 gargle before induction of GA as an effective measure to decrease the incidence &amp; severity of POST compared to lignocaine gargle.

Comparison of intravenous lidocaine and intravenous lidocaine/paracetamol in prevention of postoperative sore throat after laryngeal mask insertion

Amac: Laringeal maske airway ile genel anestezi sonrasi postoperatif bogaz agrisi sik gorulen ve istenmeyen bir komplikasyondur. Bu komplikasyonu onlemek icin literaturde pekcok ajan ve metod vardir. Fakat lidokain ve lidokain-parasetamol kombinasyonunu karsilastiran bir calisma yoktur. Bu calismanin amaci laringeal maske airway ile genel anestezi uygulanan hastalarda, sistemik lidokain ile sistemik lidokain-parasetamol kombinasyonunun postoperatif bogaz agrisi uzerine etkilerini karsilastirmaktir. Yontemler: Kesitsel calismaya laringeal maske airway ile genel anestezi altinda elektif inguinal herni cerrahisi olan, 18 yasindan buyuk ASA fiziksel statusu I-III olan 80 hasta dahil edildi. LidoPara grubuna 1mg/kg lidokain+10 mg/kg parasetamol, Lido grubuna 1mg/kg Lidokain uygulandi. Postoperatif 0, 2, 4 ve 24. saatlerde istirahat ve yutma bogaz agrisi ve ses kisikligi 4 puanli bir skala ile degerlendirildi. Bulgular: Hastalarin demografik verileri benzerdi (P>0.05). Iki grup arasinda postoperatif 0, 2, 4 ve 24. saatlerde istirahat ve yutma bogaz agrisi yonunden istatistiksel olarak anlamli farklilik yoktu. Postoperatif 4. ve 24. saatte her iki grupta da ses kisikligi yoktu. Sonuc: Kombine parasetamol ve lidokainin postoperatif istirahat ve yutma esnasindaki bogaz agrisini tek basina lidokain ile benzer sekilde etkiledigi goruldu.

Efficacy of topical agents for prevention of postoperative sore throat after single lumen tracheal intubation: a Bayesian network meta-analysis.

The optimal choice of prophylactic drugs to decrease postoperative sore throat is unclear. The objective of this network meta-analysis (NMA) was to compare and rank 11 topical agents used to prevent postoperative sore throat. Various databases were searched independently for randomized-controlled trials (RCTs) comparing topical agents used for the prevention of postoperative sore throat. Inclusion criteria were parallel group studies comparing intervention with active or inactive control and reporting postoperative sore throat. The primary outcome was postoperative sore throat at 24 hr. Secondary outcomes were early sore throat at 4-6 hr, cough, and hoarseness at 24 hr. Evidence was synthesized from 70 RCTs reporting 7,141 patients. Topical application of lidocaine, corticosteroids, ketamine, magnesium, benzydamine, water-based lubricant, and liquorice applied along the tracheal tube, to the tracheal tube cuff, gargled or sprayed were compared with intracuff air and each other. Bayesian NMA showed that magnesium (odds ratio [OR], 0.10; 95% credible interval [CrI], 0.03 to 0.26), liquorice (OR, 0.14; 95% CrI, 0.03 to 0.55), and steroid application (OR, 0.11; 95% CrI, 0.06 to 0.22) most effectively prevented postoperative sore throat at 24 hr. Topical lidocaine was the least effective intervention. Topical application of magnesium followed by liquorice and corticosteroids most effectively prevented postoperative sore throat 24 hr after endotracheal intubation.

Nebulized pharmacological agents for preventing postoperative sore throat: A systematic review and network meta-analysis.

Postoperative sore throat is one of the most common complications following endotracheal intubation. Nebulization therapy, a preferable and safety method of drug delivery, has been shown to be effective in postoperative sore throat prevention in many studies. However, the relative efficacy of various nebulized agents remains unknown. In this review, we aimed to quantify and rank order the efficacy of available nebulized agents for various postoperative sore throat-related outcomes. A comprehensive literature search of PubMed, EMBASE, CENTRAL and Google Scholar was conducted to identify eligible studies from inception to 25 May 2020. Incidence of postoperative sore throat 1hour and 24hours postoperatively and severity of postoperative sore throat 24 hours postoperatively were the primary outcomes. We conducted a Bayesian network meta-analysis to combine direct and indirect evidence to estimate the relative effects between treatments as well as the probabilities of ranking for treatments based on their protective effects. We identified 32 trials assessing 6 interventions. Overall inconsistency and heterogeneity were acceptable. Nebulized corticosteroids, magnesium, and ketamine differed from non-analgesic methods on the three primary outcomes. Based on the surface under the cumulative ranking curve, nebulized corticosteroids ranked first in almost all outcomes among the nebulized drugs. Considering only high-quality and 2-arm design studies, nebulized corticosteroids still seemed best. In conclusion, prophylactic use of nebulized corticosteroids, magnesium, and ketamine can effectively prevent postoperative sore throat, and nebulized corticosteroids appears to be the overall best approach.