Postoperative sore throat: a multifactorial problem

Background. Postoperative sore throat is one of the major complaints of general anesthesia in the postanesthesia care unit. This prospective study investigated the preventive effect of ketorolac tromethamine spray in postendotracheal-intubation-induced sore throat after general anesthesia. Methods. Surgical patients undergoing general anesthesia with endotracheal intubation were recruited from a medical center. Patients were randomly assigned to group K (treated with 5% ketorolac tromethamine spray) or group D (treated with distilled water spray). Before intubation, each endotracheal tube was sprayed with the appropriate solution by physicians over the 20 cm length of the cuff. Each group comprised 95 patients fitting the inclusion and exclusion criteria for whom complete data sets were collected. The intensity of the sore throat was measured at 1, 3, 6, and 24 h after surgery, and data were compared. Results. The two groups had similar characteristics. Postoperative sore throat was significantly less frequent in group K than in group D (p < 0.001) and the pain intensity was significantly lower in group K than in group D at each time point (all p < 0.001). Conclusions. This study demonstrated that preanesthesia 5% ketorolac tromethamine spray could effectively decrease postendotracheal-intubation-induced sore throat in patients undergoing general anesthesia.

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“…This study confirmed that postoperative sore throat is a common problem in postoperative patients as shown in the literature [17, 18]. …”

Section: Discussionsupporting

confidence: 90%

Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

Yang

Liu

Tsai

et al. 2016

BioMed Research International

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“…Baseline clinical data were derived from medical and follow-up records and included age, sex, body mass index (BMI), thyromental distance (TMD; with the neck fully extended, the distance from the thyroid notch to the chin projection was measured with a tape measure), position during surgery (including supine or non-supine position, with the latter including prone and lateral positions), surgical site (head and neck surgery (HNS) or non-head and neck surgery (NHNS), with the patients divided into the HNS group and the NHNS group), duration of anaesthesia (<4 hours or ≥4 hours), airway management (laryngeal mask or ETT), use of lidocaine cream (lidocaine cream or paraffin oil was used for tube lubrication), use of dexamethasone (prophylactic use of 10 mg within 10 min after intubation), history of smoking, history of chronic pharyngitis (patients with pre-existing sore throat were excluded, which means patients who currently have a sore throat were excluded from the entire study; ‘history of chronic pharyngitis’ means frequent pharyngitis but not currently active), postoperative analgesia (various medications including analgesics and antiemetics) and placement of a gastric drainage tube. The clinical variables associated with POST were assessed a priori based on clinical importance, scientific knowledge and predictors identified in previously published articles 6–8…”

Section: Methodsmentioning

confidence: 99%

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

Jiang

Wang

et al. 2022

BMJ Open

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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.

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“…Multiple factors are involved in the pathogenesis of POST following endotracheal intubation, which is mainly caused by the inflammatory response to intubation and the presence of the endotracheal tube (ETT) [31,32]. Furthermore, the localized inflammatory response could be aggravated by ETT motion induced by the neck hyperextension and manipulation during surgery [33,34].…”

Section: F I G U R E 2 Quality Of the Included Studies A: Risk Of Bmentioning

confidence: 99%

Pharmacological Interventions for Post-operative Sore Throat (POST): A Network Meta-analysis

2020

Signa Vitae

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Background: To study the efficacy of current post-extubation pharmacologic treatments for postoperative sore throat (POST) prevention. Method: We searched nine databases for randomized controlled trials (RCTs) assessing the efficacy of post-extubation treatments in POST prevention. A network meta-analysis was used to pool the results. Results: Of the 124 records screened, we included 13 studies with 1820 patients. Ketorolac tromethamine was found to be the most effective with the lowest POST rates (P-score = 0.99), followed by ketamine (P-score = 0.68), amyl-m-cresol (P-score = 0.67), flurbiprofen (P-score = 0.66), benzydamine hydrochloride (P-score = 0.62), magnesium (P-score = 0.33), dexamethasone (P-score = 0.30), and lidocaine (P-score = 0.07). Moreover, the following treatments were found to be significantly effective in reducing POST in comparison to control/placebo treatment: ketorolac tromethamine (OR = 0.11; [95% CI=0.05 – 0.21]) followed by ketamine (OR = 0.32; [95% CI = 0.17 – 0.62]), amyl-m-cresol (OR = 0.32; [95% CI = 0.14 – 0.73]), flurbiprofen (OR = 0.33;[95% CI = 0.13 – 0.81]), and benzydamine hydrochloride (OR = 0.36; [95% CI = 0.24 –0.54]). Conclusion: Ketorolac tromethamine, ketamine, amyl-m-cresol, flurbiprofen, and benzydamine hydrochloride were found to be significantly effective in reducing POST. Moreover, ketorolac tromethamine was the most effective and significantly better than all other treatments in reducing POST rates.

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Postoperative sore throat: a multifactorial problem

Cited by 3 publications

References 5 publications

Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

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

Pharmacological Interventions for Post-operative Sore Throat (POST): A Network Meta-analysis

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