The incidence of postoperative sore throat was evaluated prospectively in 203 orotracheally intubated patients undergoing general anesthesia for surgical procedures. Patients were randomly assigned to have either a plastic oropharyngeal airway or a gauze bite-block in place during the operation and were evaluated for the occurrence of postoperative sore throat by questionnaire the day after surgery. The incidence of postoperative sore throat was 35.2% in the oropharyngeal airway group and 42.5% in the gauze bite-block group, not a statistically significant difference (P greater than 0.05). The incidence of postoperative sore throat was significantly higher when blood was noted on the airway instruments (64.5%) than when it was not (30.9%) (P less than 0.01). There was an association, although not statistically significant, between the incidence of postoperative sore throat and intubation by an anesthesia resident with less than 1 yr experience (P = 0.064). The data from this study indicate that the intraoperative use of hard plastic oropharyngeal airways, compared with the use of soft gauze bite-blocks, does not increase the incidence of postoperative sore throat. These data also suggest that pharyngeal trauma may contribute significantly to the development of postoperative sore throat. We suggest that aggressive oropharyngeal suctioning may contribute to this pharyngeal trauma.

Study Design Retrospective analysis of lumbar computed tomographic epidurograms. Objective To evaluate the dispersal pattern of injectate after interlaminar lumbar epidural steroid injections. Summary Prior studies have evaluated the dispersal patterns of injectate after lumbar epidural steroid injections using fluoroscopy with varying results. To date, there have been no studies evaluating the dispersal pattern utilizing computerized tomography. Methods Ten epidurograms were analyzed after lumbar interlaminar epidural steroid injection. The epidurograms were examined, evaluating the dispersal pattern in longitudinal flow as well as circumferential flow. In addition, pain values were assessed with the visual analogue scale. Results Mean diffusion in the rostral direction was 9.8 cm (standard deviation 4.0 cm, range 4.0 to 15.0 cm). Mean diffusion in the caudal direction was 5.4 cm (standard deviation 1.4 cm, range 3.0 to 8.0 cm). Both rostral and caudal flow had a p value < 0.001. The circumferential flow was 360 degrees in 9 of 10 cases. In addition, there was significant (p = 0.006) reduction in pain. Conclusion Interlaminar lumbar epidural steroid injections are an effective treatment modality for various spine-related conditions. The injectate diffuses throughout the epidural space with nearly uniform circumferential flow as well as significant rostral and caudal flow.

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