Efficacy of Ketamine Gargle in Attenuating Postoperative Sore Throat

Abstract

ABSTRACT:Introduction: Postoperative sore throat (POST) is a common complication of general anesthesia with endotracheal intubation that affects the patient satisfaction after surgery. The aim of the study was to compare the effectiveness of ketamine gargle with placebo in preventing POST after endotracheal intubation. Methods: Sixty eight patients scheduled for elective surgery under general anesthesia were enrolled in this study. Patients were randomly allocated into two groups, 33 in study group and 35 in control group. Study group patients were asked to gargle with ketamine (50 mg in 1 ml mixed with 29 ml of drinking water) 10 minutes before induction for 30 seconds. Controls were made to do so with 30 ml of drinking water. POST was graded at one, two, four, and 24 hrs after operation on a four-point scale (0-3). The outcome measures were compared between two groups in terms of occurrence of POST and severity of POST at one, two, four, and 24 hr to determine the efficacy of ketamine. Results: Occurrence of POST was significantly less in study group at four hours. Severity of POST was significantly low in study group at one, two and four hours as compared to that in controls. It was comparable at 24 hours. Conclusion: Ketamine gargle significantly reduced the occurrence and severity of POST.

Topical application of ketamine to prevent postoperative sore throat in adults: A systematic review and meta‐analysis

“…Two and 37 studies included patients with an ASA status of I‐III and I‐II, respectively, while the remaining two did not report ASA status . In all, 19 studies detailed the type of surgery, and 32 studies excluded patients who underwent surgeries on the neck or pharynx . The median sample size was 90 (range, 40‐200).…”

“…In all, 30 including 2278 participants provided data on the incidence of sore throat at 24 hours after surgery/extubation . Topical application of ketamine was associated with a reduced incidence of postoperative sore throat compared to non‐analgesic methods (159/1161 vs 384/1117; RR, 0.45; 95% CI, 0.37‐0.54; P < .001; I 2 = 23.0%; Figure ).…”

“…37,57 In all, 19 studies detailed the type of surgery, [36][37][38][39]41,43,46,47,50,51,54,55,59,60,65,69,71,74,76 and 32 studies excluded patients who underwent surgeries on the neck or pharynx. [36][37][38][39][41][42][43][45][46][47][48][49][50][51][52]54,55,57,59,60,62,[65][66][67][68][69][70][71][72][73]76 The median sample size was 90 (ran...…”

“…Ketamine was topically administered as a single dose prior to surgery in all studies. Ketamine was administered as nebulization and gargle in 13 40,49,56,58,60,61,63,65,67,68,70,72,74 and 26 trials, [36][37][38][39][41][42][43][44][45][46][47][48][50][51][52][53]55,57,59,62,64,66,69,71,73,75,76 respectively, and in the other one, the endotracheal tube was lubricated with ketamine. 54 The dose of ketamine was fixed in 36 studies (50 mg, 23 studies 37,39,44,[48][49][50][51][52][53]…”

“…76 In total, 27 studies used a four-level classification system to rate the presence and severity of postoperative sore th roat [36][37][38][39][40][41][44][45][46][47][48]54,56,59,60,[62][63][64][65][66][67][68][69][70]72,74,75 and 10 reported its incidence. 42,49,50,52,55,57,58,61,71,73 Six studies and two used a visual analogue scale 44,51,55,57,71,76 and numerical rating scale, 43,53 respectively, to rate severity. We sent e-mails to 36 study authors for further information and 10 responded.…”