Efficacy of Ketamine Gargles in the Prevalence of Postoperative Sore Throat after Endotracheal Intubation

Kamble, Neha P.; Gajbhare, Manojkumar N.

doi:10.5958/2394-4994.2015.00039.6

Cited by 8 publications

(13 citation statements)

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“…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).…”

Section: Resultsmentioning

confidence: 99%

“…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 ).…”

Section: Resultsmentioning

confidence: 99%

“…Two and 37 studies included patients with an ASA status of I-III 44,65 and I-II, respectively, while the remaining two did not report ASA status. 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]…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…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]…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…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.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

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

Kuriyama

Nakanishi

Kamei

et al. 2020

Acta Anaesthesiol Scand

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Background Postoperative sore throat is a leading undesirable postoperative outcome. Ketamine is an N‐methyl‐d‐aspartate receptor antagonist and its topical application is used for chronic pain and oral/throat indications. We conducted a systematic review to assess the efficacy of preoperative, topical ketamine application for preventing postoperative sore throat. Methods We searched MEDLINE, EMBASE, and CENTRAL through September 23, 2019 for randomized controlled trials in which at least one intervention was topical ketamine to prevent postoperative sore throat in adults undergoing endotracheal intubation. The primary outcome was the incidence of sore throat at 24 hours postoperatively. The comparators were non‐analgesic controls (placebo, no treatment, or usual care) or active agents. We pooled the data using a random‐effects model. Results We included 41 randomized controlled trials involving 3784 participants. Topical ketamine was associated with reduced incidence of sore throat at 24 hours postoperatively compared to non‐analgesic methods (risk ratio, 0.45; 95% CI, 0.37‐0.54; P < .001). We found significant publication bias, but the results remained unchanged with a trim‐and‐fill analysis. Trial sequential analysis (TSA) suggested that the efficacy of topical ketamine was adequate (TSA‐adjusted 95% CI, 0.33‐0.56). The GRADE quality for this evidence was moderate. Topical ketamine was inferior to a combination of nebulized ketamine and clonidine in preventing postoperative sore throat. Conclusions Preoperative, topical ketamine application may be more effective than non‐analgesic methods in preventing postoperative sore throat. The number of studies did not suffice to determine the place of topical ketamine among agents to prevent postoperative sore throat.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%