Betamethasone for Prophylaxis of Postintubation Inflammation. a double blind study

Abstract

N 1950 Wyliel reported that 70 of 100 I unselected adult patients intubated under ether or cyclopropane anesthesia complained postoperatively of either mild or severe sore throat. Baron and Kohlmoos2 in 1951 found that 80 consecutive adults noted a mild degree of discomfort during the first 24 hours following intubation; none, however, developed important sequelae. In 1958 Wolfson2 questioned 521 adult patients directly and observed that 18.4 per cent complained of postintubation soreness; 4.5 per cent of these patients also had objective findings of hoarseness or loss of voice. Conway and associates4 in 1960 found a 38.2 per cent incidence of postintubation sore throat in a series of 642 adult patients interrogated directly. In 1964 Hartsell and Stephen? revealed that 5.7 per cent of 400 adult patients questioned indirectly complained of postintubation sore throat.Deming and OechG in 1961 described the use of dexamethosone and diphenhydramine in the treatment of severe postintubation subglottic edema in children. Jafle7 in 1964 reported the effectiveness of dexamethasone in reducing and eliminating postoperative laryngeal edema in children 5 years old and under who were intubated nasotracheally for dental procedures.The purpose of the current project was to confirm or refute our clinical impression that a single intravenous dose of corticosteroid, given at the time of intubation, reduced the morbidity of endotracheal intubation for anesthesia. METHODBy a double-blind study, the influence of the synthetic anti-inflammatory corticosteroid, bet ame t hasone, on postintubation

Intravenous injection of methylprednisolone reduces the incidence of postextubation stridor in intensive care unit patients*

“…Corticosteroids have been used in infants and children to prevent or reduce postextubation stridor by suppressing mucosal inflammation including inhibition of leukocyte migration, maintenance of cell membrane integrity, attenuation of lysosome release, and reduction of fibroblast proliferation (19,20) and tissue swelling (21). However, intravenous infusion of ␤-methasone had no protective effect in attenuation of postextubation inflammation in pediatric ICU (22). In experimental settings, dexamethasone effectively suppressed postintubation laryngeal edema in monkeys (23).…”

Lidocaine for preventing postoperative sore throat

“…If tracheal intubation is required then prophylactic use of drugs may help to alleviate postoperative sore throat. Local anaesthetics and steroids have been used for this purpose (Ayoub 1998;Goddard 1967;Herlevsen 1992;Navarro 1997). These studies showed the e ectiveness of such interventions.…”