A prospective observational cohort study on the incidence of postoperative sore throat in the pediatric population

Abstract

Background: Postoperative sore throat is common after general anesthesia. The incidence in pediatric anesthesia is variable, and the etiology unclear. Establishing risk factors would enable prevention and could improve quality of care. Aims:We performed a prospective single-center cohort study aiming to establish the incidence of postoperative sore throat in children undergoing GA with an endotracheal tube or laryngeal mask airway. Secondary aims were to identify independent risk factors for sore throat and the incidence of other postoperative complications including stridor, laryngospasm, nausea and vomiting, and delayed oral intake. Methods: Between November 2017 and April 2018, perioperative data were collected from children aged 5-16 years undergoing general, plastic, urology, renal, and orthopedic surgery. Patients completed a postoperative questionnaire within 24 hours of surgery. Results:We screened 334 children for inclusion at a tertiary pediatric hospital in the United Kingdom. One hundred and ninety-seven patients were included in the final analysis. The frequency of postoperative sore throat was 36.5%. Stridor occurred in 1.5%, laryngospasm 1.0%, postoperative nausea 59.4%, vomiting in recovery 4.6%, and delayed oral intake due to postoperative sore throat 30%. Nausea, vomiting, thirst, and pain were associated with a sore throat. Univariate analysis showed anesthesia longer than 2 hours, and use of an endotracheal tube was statistically associated with higher risk of sore throat. Over 50% of children with an endotracheal tube cuff pressure <20 cmH 2 O had a postoperative sore throat. Conclusion:Postoperative sore throat is common in children. Endotracheal intubation is associated with a greater incidence than laryngeal mask airway use. A high rate of postoperative sore throat in children with endotracheal tube cuff pressures within the recommended range suggests multifactorial etiology. To confirm validity of the identified risk factors, we would recommend a larger prospective multi-center study. K E Y W O R D Schild, incidence, intubation, laryngeal masks, pharyngitis, postoperative period

Laryngeal mask airway versus endotracheal tube for airway management during laparoscopic percutaneous extraperitoneal closure for inguinal hernia in pediatric day surgery: a retrospective analysis

“…In our study, there was a greater incidence of postoperative complications, such as nausea and sore throat, with ETT. Additionally, previous studies [3,8,12] reported that ETT was associated with a greater incidence of sore throat (13.3-54.7%) than LMA; our nding was consistent with those of previous studies. In our study, we did not observe laryngospasm and aspiration in all cases; however, such complications were reported in previous studies [5,8,12].…”

Incidence of Postoperative Sore Throat and Associated Factors Among Pediatric Patients Undergoing Surgery Under General Anesthesia at Hawassa University Comprehensive Specialized Hospital, a Prospective Cohort Study

“…The incidence of POST in children is varied from study to study, with a range of 3.3% to 50.7% in studies performed in developed countries. 10 , 11 A study done in England in 2019 found the incidence of POST was 36.5% among pediatrics undergoing surgery under general anesthesia. 11 Children have a high risk of developing POST since they have relatively smaller airways and lower mucosal perfusion pressure compared to adults, the likelihood of mucosal hypo perfusion and subsequent edema caused by airway instrumentation and cuff hyperinflation would be exaggerated in children.…”

“…A postoperative sore throat will result in delayed oral intake, and patient dissatisfaction, and it affects patients’ well-being after surgery during the immediate postoperative period. 11 , 13 One study shows that 30% of pediatric patients reporting a sore throat had delayed oral intake due to difficulty in swallowing, with no statistical difference between ETT and LMA use. 11 The delayed oral intake on the other hand will result in dehydration and can progress to delayed wound healing and increased hospital stay and increased cost.…”

“… 11 , 13 One study shows that 30% of pediatric patients reporting a sore throat had delayed oral intake due to difficulty in swallowing, with no statistical difference between ETT and LMA use. 11 The delayed oral intake on the other hand will result in dehydration and can progress to delayed wound healing and increased hospital stay and increased cost. 14…”

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

“…[5] POST has a chance to persist for several days and may lead to potential dissatisfaction in patients after operations. [5][6][7][8] It can also cause children to delay intake [9] or cause patients to have longer postoperative stays after surgery. [10] In the past few years, there have been some ways to improve PONV in enhanced recovery after surgery (ERAS) [11] ; we believe that there is room for improving ERAS pathways for POST.…”