Severity Of Postoperative Sore Throat Research Articles

Preoperative oral zinc tablet decreases incidence of postoperative sore throat.

Background and Aims:Postoperative sore throat (POST) is very frequently reported after endotracheal intubation. Zinc lozenge has been shown to reduce POST. The aim of this study was to evaluate the effect of dispersible zinc tablet on POST.Methods:Eighty-eight patients undergoing surgery with endotracheal intubation were randomly allocated into two groups, to either receive dispersible zinc tablet 40 mg (zinc group) or placebo tablet (control group), 30 min preoperatively. Assessment for incidence and severity was performed for POST, on a 4-point scale (0–3) at 0, 30 min, 2, 4, and 24 h postoperatively. The primary outcome was incidence of POST at 4 h postoperatively. Secondary outcome was severity of POST at the 5 evaluation time points postoperatively. Mann–Whitney U test, Fisher's exact, and Chi-square test were used as applicable.Results:At 4 h, there was a significantly lower incidence of POST in zinc group (6.8%) than the control group (31.8%) with a P value of 0.003. Three patients in placebo group complained of severe POST compared to none in the zinc group. The severity of POST was significantly lower in Zinc group than Placebo group at 0 min (P = 0.003), 30 min (P = 0.002), 2 h (P < 0.001), and 4 h (P = 0.001).Conclusion:Preoperative administration of 40 mg dispersible zinc tablet effectively reduces the incidence and severity of POST in the immediate postoperative period.

The Effect of Adjustment of Endotracheal Tube Cuff Pressure during Scarless Remote Access Endoscopic and Robotic Thyroidectomy on Laryngo-Pharyngeal Complications: Prospective Randomized and Controlled Trial.

Scarless remote access endoscopic and robotic thyroidectomy has been recently performed as a safe and feasible method. However, little is known about the laryngo-pharyngeal complications after surgery and the effect of adjusting the endotracheal tube cuff pressure during surgery on laryngo-pharyngeal complications. Patients were randomized into two groups: the control group (n = 52) and adjusted group (n = 52). The initial cuff pressure was set to 25 mmHg and then monitored without adjustment (control group) or with adjustment at approximately 25 mmHg (adjusted group) throughout surgery. The incidences and severity of postoperative sore throat (POST), hoarseness, dysphagia, and cough were recorded at 1, 6, 24, and 48 h after surgery. Cuff pressures of the control group changed significantly over time and were higher than those of the adjusted group. The incidence of POST was lower in the adjusted group at 24 h postoperatively (p = 0.035), and there was a significant difference in the severity of POST at 6 and 24 h postoperatively between the two groups. There were no differences in the incidence of hoarseness, dysphagia, and cough between the two groups, except dysphagia and cough at 6 h postoperatively. Therefore, intraoperative monitoring and adjustment of the cuff pressure can reduce the incidence of laryngo-pharyngeal complications.

Efficacy of ketamine soaked laryngeal pack in postoperative sore throat after nasal surgeries

Background: Post-operative sore throat (POST) occurs in 21-65% of patients which commonly arises after tracheal intubation and throat packing in patients undergoing general anaesthesia. The aim of the study was to see if ketamine soaked laryngeal pack attenuates POST in postoperative period. Methods: The present study was conducted as a prospective, randomized, double-blind clinical study. After written informed consent, 80 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-50 years, of either sex undergoing nasal surgery under general anaesthesia were enrolled. Patients were randomized into two groups; control group (C) in which laryngeal packing gauge soaked in 5 ml normal saline and group ketamine (K) in which the laryngeal packing gauge soaked in1 ml of ketamine 50 mg (50mg/ ml) with 4.0 ml of normal saline. Incidence and severity of POST was assessed at 0(on reaching post-anaesthesia care unit), 2, 4, 8, 12 and 24 hours post-operatively and graded on a four-point scale (0-3). Results: In present study there was a significant reduction in incidence and attenuation of POST at 0 (on arrival at the post-anaesthetic care unit), 2, 4, 8 hours in postoperative period in ketamine group in comparison to normal saline group. Conclusion: Laryngeal pack soaked in 50 mg ketamine is a simple and effective means in reducing the incidence and severity of postoperative sore throat in patients receiving general anesthesia with endotracheal intubation in nasal surgeries.

Comparison of efficacy of Nebulized ketamine versus lignocaine for postoperative sorethroat

Comparison of efficacy of Nebulized ketamine versus lignocaine for postoperative sorethroat - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/j.ijca.2019.078, Indian Journal of Clinical Anaesthesia-Indian J Clin Anaesth

A prospective, randomized comparison of the LMA-protector\u2122 and i-gel\u2122 in paralyzed, anesthetized patients

BackgroundIn the present study, we compare the LMA-Protector™ and the i-gel™ in terms of adequacy of the airway seal, insertion time, ease and accuracy of insertion, and the incidence of postoperative sore throat.MethodsIn 110 anesthetized and paralyzed adult patients, the i-gel™ (n = 55) or the LMA-Protector™ (n = 55) was inserted. The primary outcome was airway leak pressure. The secondary outcomes included the first-attempt success rate, insertion time, ease and accuracy of the device insertion, ease of gastric tube placement, blood staining on the device after removal, and incidence and severity of postoperative sore throat.ResultsThe airway leak pressure was higher with the LMA-Protector™ than with the i-gel™ (31 [7] cmH2O vs. 27 [6] cmH2O, respectively; P = 0.016). Insertion time was longer with the LMA-Protector™ than with the i-gel™ (27 [16] sec vs. 19 [16] sec, respectively, P < 0.001), but ease of insertion and the first-attempt success rate were not different between the two groups. The LMA-Protector™ provided a worse fiberoptic view of the vocal cords and more difficult gastric tube insertion than the i-gel™ (both P < 0.001). Blood staining on the device was more frequent with the LMA-Protector™ than with the i-gel™ (P = 0.033). The incidence and severity of postoperative sore throat were not different between the two groups.ConclusionThe LMA-Protector™ provided a better airway sealing effect than the i-gel™. However, it required a longer insertion time, provided a worse fiberoptic view of the vocal cords, and caused more mucosal injury compared to the i-gel™.Trial registrationClinicalTrials.gov (NCT03078517). Registered prior to patient enrollment, Date of registration: Mar 13, 2017.

Evaluation of efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar spine surgery in prone position: a prospective randomized double blind placebo controlled study

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p&lt;0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.

Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis.

Postoperative sore throat negatively affects patient satisfaction and recovery. We conducted a systematic review and meta-analysis to examine the efficacy of preoperative topical administration of magnesium sulfate in preventing postoperative sore throat in adult patients. We searched Medline, EMBASE, China National Knowledge Infrastructure, and the Cochrane Central Register of Controlled Trials from inception to 6 October, 2018. We included randomized-controlled trials that assessed the efficacy and safety of topical application of magnesium preoperatively in adult patients who underwent endotracheal intubation for general anesthesia. We then pooled the data using a random-effects model and conducted a trial sequential analysis on the incidence of sore throat. Our primary outcome was the incidence of sore throat at 24 hr after surgery/extubation. Our secondary outcomes included the severity of sore throat at 24 hr after surgery/extubation and adverse events. Eleven randomized-controlled trials involving 1,096 patients were included in this study. Topical application of magnesium was associated with reduced incidence of postoperative sore throat (risk ratio, 0.31; 95% confidence interval [CI], 0.21 to 0.45) as well as reduced severity of postoperative sore throat (standardized mean difference, - 2.66; 95% CI, - 3.89 to - 1.43). Three studies reported that significant adverse events were not associated with topical magnesium. The trial sequential analysis suggested that there is adequate evidence supporting the efficacy of topical magnesium in preventing postoperative sore throat. Our study suggests that preoperative topical magnesium can effectively prevent postoperative sore throat. PROSPERO (CRD42018110019); registered 26 September, 2018.

A randomised controlled trial of the effect of laryngeal mask airway manometry on postoperative sore throat in spontaneously breathing adult patients presenting for surgery at a university teaching hospital.

Laryngeal mask airways (LMAs) are widely used in anaesthesia and are considered to be generally safe. Postoperative sore throat (POST) is a frequent complication following LMA use and can be very distressing to patients. The use of an LMA cuff pressure of between 30 and 32cm of H2O in alleviating post-operative sore throat has not been investigated. To compare the occurrence of POST between the intervention group in which LMA cuff pressures were adjusted to 30-32cm of H2O and the control group in which only monitoring of LMA cuff pressures was done, to compare the severity of POST between the two study groups and to compare the LMA cuff pressures between the two study groups. Eighty consenting adult patients scheduled to receive general anaesthesia with use of an LMA were randomized into two groups of 40 patients each. Intervention group: LMA airway cuff pressures were adjusted to 30 to 32cm of H2O. Control group: Only had LMA cuff pressures monitored throughout the surgery. All patients were interviewed postoperatively at two, six and twelve hours. Data of their baseline characteristics, occurrence and severity of POST was collected. If POST was present; a Numerical Rating Scale (NRS) was used to assess the severity. Cuff pressures between the two study groups were also determined. The baseline demographic characteristics of the participants were similar. The use of manometry to limit LMA AMBU® AuraOnce™ intracuff pressure to 30-32cm H2O reduced POST in surgical patient's by 62% at 2 hours and 6 hours (Risk Ratio 0.38 95%CI 0.21-0.69)in the intervention group. The median POST pain score in the intervention group was significantly lower than the control group with scores of 0 at 2, 6 and 12 hours post operatively. Routine practice of LMA cuff inflation by anesthesiologists is variable, and the intracuff pressures in the control group were higher than in the intervention group. (P<0.001). Among this population, reduction of LMA AMBU® AuraOnce™ intracuff pressure to 30-32cm H2O reduces the occurrence and severity of POST. The LMA cuff pressures should be measured routinely using manometry and reducing the intracuff pressures to 30-32 cm of H2O recommended as best practice.

Comparison of Simple Stylet versus Lighted Stylet for Intubating the Trachea with a Direct Laryngoscope: A Randomized Clinical Trial

This study investigated the effectiveness of a lighted stylet during tracheal intubation with direct laryngoscopy. The study randomly assigned 284 patients undergoing general anesthesia to either the simple stylet (Group S) or lighted stylet (Group L) groups. In both groups, stylet-assisted intubation was performed with direct laryngoscopy. In group S, a simple stylet was used and removed when the tip of the endotracheal tube was thought to have passed the larynx. In Group L, a lighted stylet was used and removed after confirming transillumination of the suprasternal notch. The success rate at the first attempt, total intubation time, incidence of mucosal bleeding, and severity of postoperative sore throat were compared. Compared to a simple stylet, the lighted stylet significantly increased the success rate of tracheal intubation at the first attempt (128 (90%) vs. 140 (99%), p = 0.003, Groups S and L, respectively). The incidence of mucosal bleeding was significantly higher in Group S (35 (25%) vs. 19 (13%), p = 0.011, Groups S and L, respectively). The total intubation time and degree of postoperative sore throat were not significantly different between the two groups. A lighted stylet increased the success rate of tracheal intubation during stylet-assisted tracheal intubation with direct laryngoscopy.

Comparison of Three Different Methods of Attenuating Postoperative Sore Throat, Cough, and Hoarseness of Voice in Patients Undergoing Tracheal Intubation.

Context:Postoperative sore throat (POST) is a frequent and undesirable complication after general anesthesia with endotracheal intubation. Various pharmacological and non-pharmacological methods with variable success rate are used for attenuating POST. However, no single drug has been universally accepted.Aims:To compare the effect of betamethasone gel, ketamine gargles and intravenous dexamethasone on the incidence and severity of POST.Settings and Design:Prospective randomized controlled single-blinded trial conducted at a tertiary care centre.Materials and Methods:A total of 100 patients of age 18 to 70 yr, ASA class I and II, scheduled for elective surgeries under general anaesthesia were included and divided randomly in betamethasone, dexamethasone, ketamine and control groups. Endotracheal tubes were lubricated with 0.05% betamethasone gel in betamethasone group, 0.2 mg/kg of dexamethasone was administered intravenously before induction of anaesthesia in dexamethasone group, 40 mg of ketamine gargles mixed with 30 ml of saline was given 5 minutes prior to induction in ketamine group. In the control group, none of the above agents were used. During the 24 hr after the operation, we noted the occurrence and severity of POST, cough and hoarseness.Statistical Analysis Used:The demographic data, surgical time and intubation among the groups were analyzed using one-way analysis of variance. Incidence and severity of POST, cough and hoarseness of voice among the groups were analyzed utilizing Chi-square test.Results:Incidence of POST at one hour was found to be significantly less in betamethasone group (16%) and dexamethasone group (20%) in comparison to the control group (48%). The incidence of POST at 4 hours and 24 hours were found to be comparable. The frequency of hoarseness and cough at 1 hour, 4 hour and 24 hours were similar in all the groups.Conclusions:Prophylactic betamethasone gel application and intravenous dexamethasone administration before induction of anaesthesia resulted in clinically important and statistically significant decreases in the incidence of POST only in early postoperative period.

Incidence and Severity of Postoperative Pharyngolaryngeal Complications following Use of Baska Mask versus Endotracheal Intubation.

Background:Use of Baska Mask, since a supraglottic airway device, could result in low incidence of postoperative pharyngolaryngeal complications.Aims:The objectives were to compare the effect of Baska Mask versus endotracheal intubation on the incidence and severity of postoperative sore throat (POST), postoperative hoarseness of voice (POHV), and postoperative cough (POC).Settings and Design:This prospective randomized study was conducted in a tertiary care teaching institute in 120 patients undergoing short laparoscopic surgeries.Subjects and Methods:Airway was secured using with low-pressure, high-volume cuffed endotracheal tube in Group T and with Baska Mask in Group B. POST, POC, and POHV were assessed at 2, 6, 12, and 24 h after surgery. Those with Grade III score throat were managed by gargling with dispersible aspirin 75 mg.Statistical Analysis Used:Pearson's Chi-square test, Fisher's exact test, and independent sample t-test were used as applicable.Results:Group B patients required significantly more attempts at securing airway. Incidence of POST was significantly higher in Group T as compared to that Group B at 2, 6, 12, and 24 h after surgery. POC was significantly more in Group T at 2, 6, and 12 h. No patient in Group B had POC at 12 and 24 h. POHV showed significantly higher incidence in Group T at 2 and 6 h. No patient in Group B had hoarseness at 6, 12, and 24 h.Conclusion:Use of Baska Mask as compared to endotracheal intubation significantly reduces the incidence and severity of pharyngolaryngeal complications such as POST, POC, and POHV in patients undergoing short laparoscopic surgeries.

Comparison of Two Supraglottic Airway Devices: I-gel Airway and ProSeal Laryngeal Mask Airway Following Digital Insertion in Nonparalyzed Anesthetized Patients.

Aims:The study is aimed to compare the efficacy of I-gel and ProSeal laryngeal mask airway (PLMA) in nonparalysed anesthetized individuals following manufacturer-recommended digital insertion.Materials and Methods:In this prospective randomized observational study, 40 American Society of Anesthesiologists I and II patients, aged 18–65 years scheduled for elective surgical procedures were allocated either to PLMA group (Group P, n = 20) or the I-gel group (Group I, n = 20). Following digital insertion of PLMA or I-gel, the following parameters were compared: insertion time, ease of insertion, number of attempts, failed insertion, airway reaction during insertion, oropharyngeal leak (OPL) pressure, and gastric insufflation on auscultation. Fiberoptic view of both the channels of the airway devices and ease of insertion of 12 F Ryle's tube through gastric drain channel were graded. Postoperative complications were also noted.Results:First attempt and overall insertion success were similar (PLMA, 85% and 100%; I-gel 80% and 100%, respectively). Mean (standard deviation) insertion times were similar (PLMA, 27.40 [11.51] s; I-gel 25.45 [9.03] s). Mean OPL pressure was 3.5 cm H2O higher with PLMA (P < 0.012). The passage of Ryle's tube was easier through I-gel than PLMA. Grade I glottic view (full view of the vocal cords) was visible in 17 (85%) patients who were managed with I-gel whereas only 9 (45%) patients had Grade I view in the PLMA group.Conclusion:The time required for digital insertion of PLMA and I-gel in nonparalyzed anesthetized patients is similar but PLMA forms a better oropharyngeal seal. I-gel is better positioned over the laryngeal framework and esophagus. I-gel allows easier passage of Ryle's tube through its drain channel than PLMA. The incidence and severity of postoperative sore throat and hoarseness was higher with PLMA.

Efficacy of dexamethasone in reducing the severity of postoperative sorethroat after endotracheal intubation

Efficacy of dexamethasone in reducing the severity of postoperative sorethroat after endotracheal intubation

Comparison Between Lidocaine Inhalation and Intravenous Dexamethasone in Reducing Postoperative Sore Throat Frequency After Laryngeal Mask Insertion.

BackgroundThe frequency of postoperative sore throat (POST) after laryngeal mask airway insertion (LMA) was relatively high. Lidocaine might reduce the pain and inflammatory response. Additionally, inhalation form might result in a better distribution, which results in a better airway analgesia and minimal systemic effect.ObjectivesTo compare the incidence of sore throat post LMA insertion after 1.5 mg/kg of lidocaine inhalation and 10 mg of intravenous dexamethasone.MethodsThis was a single-blinded randomized clinical trial, which included 128 patients who underwent ophthalmic surgery under general anesthesia with LMA insertion. Inclusion criteria were individuals 18 - 65 years old, ASA 1 or 2, Mallampati class I or II, and no sore throat before surgery. After University of Indonesia Research Ethical Committee approval and informed consent, all subjects were randomly divided into two groups: lidocaine inhalation group, which would receive lidocaine inhalation 2% 1.5 mg/kg (additional NaCl 0.9% until total 6 mL volume) and intravenous 2 mL NaCl 0.9%, and dexamethasone group, which would received NaCl 0.9% inhalation (6 mL volume) and dexamethasone 10 mg intravenously 10 minutes before LMA insertion. POST incidence and pain severity assessment were done 2 hours postoperatively. Statistical analysis were done with SPSS version 21.ResultsThere were 10.9% of subjects in the lidocaine inhalation group and 9.4% subjects in the dexamethasone group who suffer from POST postoperatively (P > 0.05). The median of POST pain in the lidocaine inhalation group was 0 (0 - 1), whereas in dexamethasone group it was 0 (0 - 3). This study did not find any side effects on both groups.ConclusionsLidocaine inhalation 1.5 mg/kg was proportional to intravenous dexamethasone 10 mg in reducing the incidence and severity of POST after LMA insertion.

Efficacy of dexamethasone in reducing the incidence of postoperative sore throat: a double blind randomized study

Introductions: Postoperative sore throat (POST) is a commonly seen adverse event after general anesthesia with endotracheal intubation. Dexamethasone, a potent corticosteroid with anti-inflammatory action is the most popular steroid studied in this regard with positive results. &#x0D; Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on one hundred and ten adult patients of either sex, American Society of Anesthesiologists physical status I &amp; II, undergoing elective surgeries requiring endotracheal tube intubation. After obtaining written informed consent, they were randomly divided into Control (A, n=55) and Dexamethasone (B, n=55) groups and received either an injection of Dexamethasone (Group B) 8 mg intravenously or an equivalent volume of Normal Saline (Group A) just before entering the operating theatre. All the patients received a similar anesthesia with endotracheal tube intubation and at the end of surgery, extubated and transferred to the post-anesthesia care unit. The incidence and severity of sore throat were assessed at 1, 6 and 24 hours post-extubation. Severity of sore throat were graded on a 4 point scale, p &lt;0.05 was considered significant. &#x0D; Results: Incidence of POST in Dexamethasone group was found significantly low compared to the control group up to six hours (p&lt;0.05) but was comparable at 24 hours post extubation. Severity of POST in the study group was of lower grade in compare to control group. &#x0D; Conclusions: Prophylactic intravenous Dexamethasone 8 mg administered to patients undergoing elective surgeries requiring endotracheal tube intubation significantly reduces the incidence and severity of POST up to six hours post-extubation.

Oral flurbiprofen spray for postoperative sore throat and hoarseness: a prospective, randomized, double-blind, placebo-controlled study.

Sore throat and hoarseness are common complications after surgery. Flurbiprofen spray has been successfully used for treatment of oral inflammations, but its effects on postoperative sore throat and hoarseness are unknown. We conducted this study to evaluate the effectiveness of flurbiprofen spray on postoperative sore throat and hoarseness, by comparing it with benzydamine hydrochloride spray and placebo. One hundred fifty patients who were scheduled to undergo elective ear surgery were enrolled. Patients were randomized to three groups of 50 patients each; flurbiprofen oral spray, benzydamine hydrochloride oral spray and placebo spray groups. Patients received sprays just before intubation, and the incidence and severity of postoperative sore throat and hoarseness were evaluated by a blinded investigator at 0, 1, 6 and 24-hour post extubation. Patients were also questioned for possible side effects at all time points. The sore throat severity scores were significantly lower in treatment groups when compared to placebo group at all time points (P=0.003/108). Similarly, the incidence of sore throat was significantly lower in both of the treatment groups (P=0.007/104). The incidence of hoarseness and hoarseness scores were significantly lower in treatment groups when compared to placebo group (P=0.006/105 and P=0.005/104, respectively). While none of the patients complained of any adverse effects in flurbiprofen group, only two patients in benzydamine hydrochloride group experienced numbness. Both oral flurbiprofen and benzydamine hydrochloride sprays were found to be more effective than placebo in decreasing the incidence and severity of postoperative sore throat and hoarseness, with no adverse effects.

The Effect of Zinc Lozenge on Postoperative Sore Throat: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study.

Postoperative sore throat (POST) is commonly seen after endotracheal intubation, and oral zinc prevents oral mucositis associated with chemotherapy. This study is designed to evaluate the effects of administration of zinc lozenges on POST. Seventy-nine patients undergoing low- or moderate-risk surgery with endotracheal intubation were randomly assigned into 2 groups: Control group received placebo and zinc group received 40-mg zinc lozenges 30 minutes preoperatively. Patients were assessed for incidence and severity (4-point scale, 0-3) of POST at 0, 2, 4, and 24 hours postoperatively. The primary outcome was incidence of POST at 4 hours after surgery. The secondary outcomes were the incidence of POST at 0, 2, and 24 hours and the severity of POST. At 4 hours, there was a significantly lower incidence of POST in the zinc group, 7%, than the control group, 29% (P = .046). The incidence of POST at 0 hour was 0% in zinc group and 24% in control group (P = .004). The highest incidence of POST occurred at the second hour after surgery, with the rate of 10% in the zinc group and 34% in the control group (P = .0495). The incidence of POST at 24 hours was 13% in zinc group and 24% in control group (not significant). The severity of POST was significantly lower in the zinc group for mild (P = .003) and moderate (P = .004) POST. The administration of a single dose of 40-mg zinc lozenge 30 minutes preoperatively is effective to reduce both incidence of POST in the first 4 hours and severity of mild and moderate POST in the immediate postoperative period.

Controlled comparison between betamethasone gel and lidocaine jelly applied over endotracheal tube in reducing postoperative sore throat, cough, and hoarseness of voice

Background and Aims: Postoperative sore throat (POST), cough (C), and hoarseness of voice (H) are common, uncomfortable, and frequently ignored sequel after endotracheal intubation. They are likely to be the consequences of local irritation and inflammation so may be amenable to locally administered steroids. Systemic corticosteroids have been shown to prevent the postextubation upper airway obstruction after long-term intubation. Various reports about the efficacy of pharmacological and nonpharmacological measures on complications of intubation have been published. Materials and Methods: A prospective, randomized, hospital-based experimental study including 180 patients (American Society of Anesthesiologists physical status I and II; age group 18–45 years; and scheduled for elective surgery requiring general endotracheal anesthesia were randomly allocated into three groups – Group I, II, and C). Incidence and severity of POST, C, and H were compared using betamethasone gel, lignocaine jelly, or when nothing was applied. Incidence of coughing or bucking and hemodynamic variability was also compared between groups. Quantitative variables in various groups were expressed as mean ± standard deviation and compared using ANOVA and/or unpaired t-test between the groups and paired t-test within each group. Qualitative variables were expressed as frequencies/percentages and compared using Chi-square test. Results: Incidence and severity of POST, C, H, and coughing/bucking was maximum in Group C, followed by Group II and least in Group I (P Conclusion: Betamethasone gel applied over tracheal tube effectively reduces the incidence and severity of POST, C, and H as compared to lignocaine jelly or when nothing was applied.

Effect of nebulized ketamine versus betamethasone gel on postoperative pharyngo-laryngeal complications after proseal laryngeal mask insertion in day case surgery

Background General anesthesia with laryngeal mask airway can lead to trauma of the airway mucosa resulting in postoperative pharyngo-laryngeal complications. We compared between the effects of betamethasone gel applied over proseal laryngeal mask and nebulized ketamine in reducing pharyngo-laryngeal complications such as sore throat, hoarseness of voice, dysphagia, and cough during the first, 12 postoperative hours after elective day case surgical procedures. Patients and methods In all, 120 patients (aged 16–45 year) American Society of Anesthesiologists physical status I and II, scheduled for elective day case surgery with proseal laryngeal mask, were enrolled into this prospective, randomized, double-blinded study. The patients were randomly allocated into four groups of 30 participants each: group C received nebulized saline and lubricant gel over laryngeal mask; group B received nebulized saline and 0.05% betamethasone gel over laryngeal mask; group K received nebulized ketamine (1 mg/kg) and lubricant gel over laryngeal mask; group KB received nebulized ketamine (1 mg/kg) and 0.05% betamethasone gel over laryngeal mask. The incidence and the severity of postoperative sore throat, hoarseness of voice, dysphagia, and cough were graded at 30 min, 2, 4, 8, and 12 h. Results The incidence and severity of postoperative sore throat, hoarseness of voice, dysphagia, and cough were significantly lower in groups KB, K, and B, compared with control group (P&lt;0.05). The incidence and severity of postoperative sore throat, hoarseness of voice, dysphagia, and cough were lower in group KB compared with groups K and B at all times after removal of laryngeal mask up to 12 h without significant difference. Conclusion The prophylactic use of betamethasone gel or nebulized ketamine significantly reduced the incidence and severity of postoperative pharyngo-laryngeal complication. Betamethasone gel and nebulized ketamine were significantly more effective than using each of these drugs alone.

Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough.

Background and Aims:Post-operative sore throat (POST) is often considered an inevitable consequence of tracheal intubation. This study was performed to compare the effect of inhaled budesonide suspension, administered using a metered dose inhaler, on the incidence and severity of POST.Methods:In this prospective randomised study, 46 patients undergoing laparoscopic surgeries lasting <2 h were randomly allotted into two equal groups. Group A received 200 μg budesonide inhalation suspension, using a metered dose inhaler, 10 min before intubation, and repeated 6 h after extubation. No such intervention was performed in Group B. The primary outcome was the incidence and severity of POST. Secondary outocomes included the incidence of post-operative hoarseness and cough. Pearson's Chi-square test, Fisher's exact test and Independent sample t-test were used as applicable.Results:Compared to Group B, significantly fewer patients had POST in Group A at 2, 6, 12 and 24 h (P < 0.001). Although more patients in Group B had post-operative hoarseness of voice and cough at all-time points, the difference was statistically significant only at 12 h and 24 h for post-operative hoarseness and at 2 h and 12 h for post-operative cough. Severity as well as the incidence of POST showed downward trends in both groups over time, and by 24 h no patient in Group A had sore throat.Conclusion:Inhaled budesonide suspension is effective in significantly reducing the incidence and severity of POST.