Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: A randomized controlled trial.

Postoperative sore throat (POST) is common after surgeries requiring a breathing tube and can cause patient discomfort and delayed discharge. In a randomized trial of 405 adults undergoing short pelvic laparoscopic surgery, intra-cuff dexamethasone reduced POST symptoms more effectively than intra-cuff ketamine or normal saline. At 2 hours after extubation, 92.59% of patients receiving dexamethasone had no POST symptoms, compared with 74.07% for ketamine and 67.41% for saline. Dexamethasone also led to the lowest rates of postoperative hoarseness and cough across all measured time points. Intra-cuff dexamethasone appears to be a favorable option for relieving POST, hoarseness, and cough in the early postoperative period.

Study at a glance

Abstract

Postoperative Sore Throat (POST) may result in patient dissatisfaction and distress, which could possibly delay discharge. Various pharmacological and non-pharmacological approaches have been explored, yet effective techniques remain elusive. This research evaluates the impact of intra-cuff Dexamethasone, Ketamine, and normal saline on alleviating POST symptoms. In this randomized controlled trial, 405 adult patients aged 18‒60 years undergoing short pelvic laparoscopic surgeries under general anesthesia for 1‒3 hours requiring endotracheal intubation were enrolled. Patients were randomized into Group N (intra-cuff normal saline), Group D (intra-cuff Dexamethasone), and Group K (intra-cuff Ketamine). The primary outcome of this study was the incidence and severity of POST at 2-, 6-, 12-, and 24-hours after extubation. Secondary outcomes were the incidence and severity of postoperative hoarseness of voice and postoperative cough at various time intervals. There were more patients in Group D without symptoms of POST (92.59%) than in Group K (74.07%) and Group N (67.41%) (p < 0.0001) at 2 hours. Similarly, more patients had no symptoms of postoperative hoarseness of voice (93.33%) and postoperative cough (93.33%) in Group D at 2 hours. Furthermore, Group D consistently exhibited the lowest incidence of POST, postoperative hoarseness of voice, and postoperative cough at various time intervals. Intra-cuff Dexamethasone appears to be a favourable intervention for symptom alleviation of POST, postoperative hoarseness of voice, and postoperative cough during the early postoperative period. CTRI/2022/08/044664.