Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Chen, Yanqing; Li, Jiping; Xiao, Jie

doi:10.1007/s00405-014-2896-7

Cited by 15 publications

(13 citation statements)

References 25 publications

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“…[ 24 ] Use of budesonide inhalation suspension 200 mcg 10 min prior to intubation and 6 and 24 h after extubation in thyroid surgery under GA exhibited significantly less severe sore throat and hoarseness at 1 h and 24 h following extubation. [ 25 ] Gabapentin (100 mg) when administered orally, 1 h before anaesthesia had a lower incidence of POST than the placebo group (47% vs. 78%, P = 0.038). [ 26 ] Endotracheal intubation done with Glide Scope ® video laryngoscope was found to attenuate POST in patients as compared to Macintosh blade with normal airway patients, at 6 and 24 h after surgery.…”

Section: Discussionmentioning

confidence: 99%

Nebulized ketamine decreases incidence and severity of post-operative sore throat

2015

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Background and Aims:Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST.Methods:We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3).Results:The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02).Conclusion:Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects.

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Section: Discussionmentioning

confidence: 99%

Nebulized ketamine decreases incidence and severity of post-operative sore throat

2015

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“…Similarly, betamethasone gel (0.05%) reduced the incidence compared with 2% lidocaine gel [24]. Preoperative inhaled fluticasone [25] and budesonide [26] have also been shown to reduce the incidence and severity of postoperative sore throat.…”

Section: Preventionmentioning

confidence: 99%

Postoperative sore throat: a systematic review

2016

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Summary Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre‐existing lung disease, prolonged duration of anaesthesia and the presence of a blood‐stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double‐lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i‐gel™ supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence.

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“…Its usefulness in prevention of POST had been investigated with promising results when administered before induction of anaesthesia through oxygen driven atomising inhalation. [ 5 ] The dose of budesonide used in our study was well within the therapeutic limits used in bronchial asthma. Since for each patient, it was used only twice, 6 h apart, chance of overdosing or development of side effects were minimal.…”

Section: Discussionmentioning

confidence: 72%

“…Based on a previous study by Chen et al . [ 5 ] considering the incidence of the POST in patients who received budesonide nebulization as compared to control group (72.5% vs. 87.5%), with 95% confidence interval and 80% power, minimum sample size to obtain statistically significant result was calculated as 30. We recruited 46 patients with 23 in each group.…”

Section: Methodsmentioning

confidence: 99%

Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough

et al. 2018

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Background and Aims:Post-operative sore throat (POST) is often considered an inevitable consequence of tracheal intubation. This study was performed to compare the effect of inhaled budesonide suspension, administered using a metered dose inhaler, on the incidence and severity of POST.Methods:In this prospective randomised study, 46 patients undergoing laparoscopic surgeries lasting <2 h were randomly allotted into two equal groups. Group A received 200 μg budesonide inhalation suspension, using a metered dose inhaler, 10 min before intubation, and repeated 6 h after extubation. No such intervention was performed in Group B. The primary outcome was the incidence and severity of POST. Secondary outocomes included the incidence of post-operative hoarseness and cough. Pearson's Chi-square test, Fisher's exact test and Independent sample t-test were used as applicable.Results:Compared to Group B, significantly fewer patients had POST in Group A at 2, 6, 12 and 24 h (P < 0.001). Although more patients in Group B had post-operative hoarseness of voice and cough at all-time points, the difference was statistically significant only at 12 h and 24 h for post-operative hoarseness and at 2 h and 12 h for post-operative cough. Severity as well as the incidence of POST showed downward trends in both groups over time, and by 24 h no patient in Group A had sore throat.Conclusion:Inhaled budesonide suspension is effective in significantly reducing the incidence and severity of POST.

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Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Cited by 15 publications

References 25 publications

Nebulized ketamine decreases incidence and severity of post-operative sore throat

Nebulized ketamine decreases incidence and severity of post-operative sore throat

Postoperative sore throat: a systematic review

Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough

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