Development of a nomogram for prediction of postoperative sore throat in patients under general anaesthesia: a single-centre, prospective, observational study

Abstract

ObjectivesPostoperative sore throat (POST) is very common in patients under general anaesthesia. However, there is no effective clinical predictive model for reducing its occurrence. The objective of this study was to estimate the risk factors for POST in patients after general anaesthesia by designing a nomogram.DesignA prospective study.SettingThis study was conducted in a large tertiary hospital.ParticipantsPatients aged 18–85 years old who received general anaesthesia with either an endotracheal tube or supraglottic airway and of American Society of Anesthesiologists classification level Ⅰ–III.ResultsA total of 442 patients were enrolled in this study, with a POST incidence of 44.1%. The results showed that younger age (≤55 years), surgical site (head and neck surgery), duration of anaesthesia (≥4 hours) and history of chronic pharyngitis were independent risk factors for POST in general anaesthesia patients. Receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the nomogram. The area under the ROC curve was 0.784 and the C-index was 0.779.ConclusionA nomogram combining age, surgical site, duration of anaesthesia and history of chronic pharyngitis is potentially useful in predicting POST under general anaesthesia.Trial registration numberChiCTR-ROC-17013258; Post-results.

Postoperative Sore Throat

“…There have been different results depending on the population studied and have found conflicting results. Some authors have found a higher incidence amongst young patients [2], and others claim the incidence is higher amongst geriatric patients [3]. It is well known that as we age, our nervous fibers become less sensitive to pain stimuli, so it is probable that the risk factor of old age is more associated to difficult airways that are common in geriatric patients, rather than old age itself.…”

“…POST is importantly linked to the use of larger lumen endotracheal tubes (ETT). Many authors have found a lower incidence of POST when reducing the ETT size [2,3,5,6] even by 0.5 mm. Traditionally, larger ETT were selected to reduce airflow resistance and provide better ventilation, but this intervention has little significance when the ventilation is transitory as is in a surgical procedure.…”

“…Long procedures resulting in endotracheal intubation for 3 hours or more was highly associated to POST [3]. Gynecologic surgery has also been linked to higher incidence of POST that can probably be explained by the extreme Trendelenburg position required for many laparoscopic gynecologic procedures which elevate the pressure in the airway secondary to blood pooling in the upper body [9].…”

Effects of preoperative inhaled budesonide combined with intravenous dexamethasone on postoperative sore throat in patients who underwent thyroidectomy: A randomized controlled trial

“…Although POST is a minor complication, it reduces patient satisfaction and extends the hospital stay. [ 1 , 2 ] The incidence of POST ranges between 12.1% and 70%, depending on the study. [ 3 ] The etiology of POST involves damage to the airway mucosa due to endotracheal intubation under GA. [ 4 ] The symptoms of POST include pain, discomfort, hoarseness, and coughing.…”

Effect of superior laryngeal nerve block in alleviating sore throat after application of i-gel supraglottic airway: a randomized controlled trial

“…Anesthetic agent spray or gargle, steroids administration, are proposed to reduce the incidence of sore throat, but yield controversy on the efficacy of the treatments [ 2 , 6 , 7 ]. Except for local pharyngeal mucous injury, other risk factors such as age, surgical duration, gender were also involved in initiating POST after SAD insertion [ 3 , 8 , 9 ].…”