Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: A randomized controlled trial.
Arun Mukesh, Ankur Sharma, Priyabrat Karan, Darshna Rathod, Shilpa Goyal, Kamlesh Kumari, Manbir Kaur, Tanvi Meshram, Pradeep Bhatia
Brazilian journal of anesthesiology (Elsevier) June 13, 2025 DOI: 10.1016/j.bjane.2025.844651 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 405 |
| Population | Adult patients aged 18–60 years undergoing short pelvic laparoscopic surgeries under general anesthesia requiring endotracheal intubation |
| Interventions | Intra-cuff Dexamethasone Intra-cuff Ketamine Intra-cuff normal saline |
| Duration | 24 hours after extubation |
| Topics | Ketamine Esketamine |
| Keywords | Cough Hoarseness Postoperative pain management Anesthesia Endotracheal intubation Surgical recovery Dexamethasone therapy |
| Key findings | Intra-cuff dexamethasone resulted in a higher proportion of patients without postoperative sore throat (92.59%) at 2 hours compared to intra-cuff ketamine (74.07%) or normal saline (67.41%), and consistently reduced hoarseness and cough. |
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.
Comparable studies
Other randomized controlled trials on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Healthy human subjects recruited from the community | 1994 | Randomized controlled trial | n = 19 |
| Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode | 2013 | Randomized controlled trial | n = 73 |
| Remifentanil-induced Postoperative Hyperalgesia and Its Prevention with Small-dose Ketamine Patients undergoing major abdominal surgery | 2005 | Randomized controlled trial | n = 75 |
| Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder Patients with chronic PTSD related to a range of trauma exposures | 2014 | Randomized controlled trial | n = 41 |
| Ketamine-Induced Deficits in Auditory and Visual Context-Dependent Processing in Healthy Volunteers Healthy volunteers | 2000 | Single-blind placebo-controlled study | n = 20 |