Evaluation of efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar spine surgery in prone position: a prospective randomized double blind placebo controlled study

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p<0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.

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To Compare Frequency of Sore Throat in Early Postop period in General Anesthesia and Endotracheal Intubation for Abdominal Surgeries who are given Dexamethasone and Normal Saline

10.53350/pjmhs211561227 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1227-1229

Author(s):

R. Farooqi ◽

T. Iqbal ◽

M. S. Mehmood ◽

Z. Y. Bhatti ◽

F. Liaquat

Keyword(s):

General Anesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Normal Saline ◽

Controlled Study ◽

Control Group ◽

Chi Square ◽

Group I ◽

Chi Square Test ◽

Group Ii

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia

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Effect of Intravenous Dexamethasone on Propofol Injection Pain: A Randomized Placebo Controlled Study

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v25i1.45192 ◽

2020 ◽

Vol 25 (1) ◽

pp. 28-33

Author(s):

Muhammad Sazzad Hossain ◽

Md Afzalur Rahman ◽

Mamunur Rashid ◽

Monirul Islam ◽

Anisur Rahman Babu ◽

...

Keyword(s):

Normal Saline ◽

Saline Group ◽

Controlled Study ◽

Injection Pain ◽

Moderate Pain ◽

Dexamethasone Group ◽

Group I ◽

Elective Surgical Procedure ◽

American Society ◽

American Society Of Anesthesiologists

Background and aim of study: Pain on propofol injection (POPI) is a common problem. None of the commonly used methods completely attenuate the pain. Inflammatory response to propofol contributes to the pain. This study was conducted to compare the efficacy of dexamethasone in attenuation of pain following intravenous injection of propofol. Materials and methods: A total of 80 adult patients were scheduled in this study with either sex, ASA (American Society of Anesthesiologists) grade I and II, for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 0.15 mg/kg of intravenous dexamethasone in 5 ml normal saline and Group II (placebo group) received 5 ml of 0.9% intravenous normal saline, following exsanguination and occlusion of the vein of the arm. This was followed by 0.5 mg/kg of propofol intravenously.The patients were asked to report their pain during injection of propofol according to the McCririck and Hunter scale. Results: The incidence of pain experienced in dexamethasone group was 45% patients and in saline group was 70% patients (p<0.05). The severity of POPI was also lower in dexamethasone group than the saline group (p<0.05). The incidence of mild and moderate pain in dexamethasone groups versus saline group was 30% versus 45% and 15% versus 25% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Pretreatment with intravenous dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain on propofol injection (POPI). Bangladesh J Otorhinolaryngol; April 2019; 25(1): 28-33

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Efficacy of dexamethasone in reducing the incidence of postoperative sore throat: a double blind randomized study

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v5i1.24034 ◽

2018 ◽

Vol 5 (1) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

Sujita Manandhar ◽

Kishor Manandhar ◽

Sharad Khakrel

Keyword(s):

Endotracheal Tube ◽

Sore Throat ◽

Randomized Study ◽

Saline Group ◽

Controlled Study ◽

Control Group ◽

Lower Grade ◽

Postoperative Sore Throat ◽

Double Blind ◽

Dexamethasone Group

Introductions: Postoperative sore throat (POST) is a commonly seen adverse event after general anesthesia with endotracheal intubation. Dexamethasone, a potent corticosteroid with anti-inflammatory action is the most popular steroid studied in this regard with positive results. Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on one hundred and ten adult patients of either sex, American Society of Anesthesiologists physical status I & II, undergoing elective surgeries requiring endotracheal tube intubation. After obtaining written informed consent, they were randomly divided into Control (A, n=55) and Dexamethasone (B, n=55) groups and received either an injection of Dexamethasone (Group B) 8 mg intravenously or an equivalent volume of Normal Saline (Group A) just before entering the operating theatre. All the patients received a similar anesthesia with endotracheal tube intubation and at the end of surgery, extubated and transferred to the post-anesthesia care unit. The incidence and severity of sore throat were assessed at 1, 6 and 24 hours post-extubation. Severity of sore throat were graded on a 4 point scale, p <0.05 was considered significant. Results: Incidence of POST in Dexamethasone group was found significantly low compared to the control group up to six hours (p<0.05) but was comparable at 24 hours post extubation. Severity of POST in the study group was of lower grade in compare to control group. Conclusions: Prophylactic intravenous Dexamethasone 8 mg administered to patients undergoing elective surgeries requiring endotracheal tube intubation significantly reduces the incidence and severity of POST up to six hours post-extubation.

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The Effect of Nebulized Magnesium Sulphate on the Incidence of Postoperative Sorethroat

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.39 ◽

2020 ◽

Vol 5 (1) ◽

pp. 185-190

Author(s):

T. Padma ◽

Raju B ◽

Raviraj GS

Keyword(s):

Clinical Study ◽

Sore Throat ◽

Normal Saline ◽

Magnesium Sulphate ◽

Age Group ◽

Postoperative Sore Throat ◽

Medical College ◽

Randomized Clinical Study ◽

Significant Difference ◽

Definition Of

Background: Postoperative sore throat (POST) is a well-recognized complication that remains unresolved in patients undergoing endotracheal intubation for general anaesthesia. The wide variation in these figures is presumably due to different skills and techniques among anesthetists and to differences between patients in the definition of sore throat. The main aim is to study the attenuating effect of Magnesium sulphate nebulization on the incidence of post-operative sore throat. Subjects and Methods: This is a prospective randomized clinical study. A total number of 100 patients of ASA grade 1 & 2, in the age group of 18 - 60 years. The study has been carried out at Sri Venkateswara Ram Narayana Ruia Government General Hospital, Sri Venkateswara Medical College, Tirupati, over a period of 12 months. Results: There was no significant difference among the groups in terms of age, gender and weight. Whereas Magnesium sulphate significantly lessens the POST during swallowing at 4th hour as compared to Normal saline (p< 0.05) and this statement can be attributed to any population. Conclusion: Post-operative sore throat is one of the most common undesirable anesthesia-associated problems in the patients undergoing GA with an endotracheal tube for routine surgical cases for up to 24 h. Magnesium sulphate was significantly reduces the incidence of POST compared to Normal saline , and it is safe, simple and effective in reducing postoperative sore throat.

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A COMPARATIVE STUDY BETWEEN LIGNOCAINE NEBULISATION AND MAGNESIUM SULPHATE NEBULISATION FOR ATTENUATION OF POSTOPERATIVE SORE THROAT

10.36106/ijsr/4617478 ◽

2021 ◽

pp. 9-11

Author(s):

Dhiman Neogi ◽

Sudeshna Bhar Kundu ◽

Chaitali Biswas ◽

Anisha Ghosh ◽

Sourav Das

Keyword(s):

Sore Throat ◽

Postoperative Period ◽

Magnesium Sulphate ◽

Severity Score ◽

Elective Surgery ◽

Statistical Tests ◽

Orotracheal Intubation ◽

Controlled Study ◽

Postoperative Sore Throat ◽

Double Blind

BACKGROUND: Postoperative sore throat (POST) is a common complication following general anaesthesia (GA) with orotracheal intubation. Both magnesium sulphate nebulisation and lignocaine nebulisation have been reported to be used successfully to reduce the incidence and severity of POST. Till date, no study has been reported comparing the efcacy of these two drugs for attenuation of POST. Therefore, the aim of this study was to compare the efcacy of preoperative lignocaine nebulisation and magnesium sulphate nebulisation in reducing the incidence and severity of POSTin patients undergoing GAwith orotracheal intubation. METHODS:Aprospective, double blind, parallel group, randomised, controlled study was conducted on 96 patients, aged between 18-50 years, ASAphysical status I and II, undergoing elective surgery under GAwith orotracheal intubation. Patients were randomly allocated into two groups, group L and group M. The patients in group L (n=48) received 4% lignocaine nebulisation (3 ml) and those in group M (n=48) received isotonic magnesium sulphate nebulisation (3 ml) over 15 minutes ending 5 minutes prior to induction of GA. The patients were assessed for incidence and severity of POST, cough, hoarseness of voice and dysphagia at 5 minutes and thereafter at 1, 4, 12, 24 and 48 hours in the postoperative period. All data were compared using appropriate statistical tests. RESULTS: POST four-point scale was found to be signicantly lower in group M in comparison to group L at 5 minutes and 1 hour in the postoperative period. Hoarseness severity score and dysphagia severity score were also signicantly lower in group M at 1 hour postoperatively. CONCLUSION: In comparison to lignocaine nebulisation; magnesium sulphate nebulisation was found to be more effective to reduce the incidence and severity of POST, hoarseness of voice, and dysphagia particularly in the early postoperative period.

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Betamethasone Gel versus Intravenous Dexamethasone as Prophylaxis against Postoperative Sore Throat

Delta Medical College Journal ◽

10.3329/dmcj.v6i2.38215 ◽

2018 ◽

Vol 6 (2) ◽

pp. 73-77 ◽

Cited By ~ 1

Author(s):

Muhammad Sazzad Hossain ◽

Mamunur Rashid ◽

Anisur Rahman Babu ◽

Devashis Saha ◽

Debasish Banik

Keyword(s):

Endotracheal Tube ◽

General Anaesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Lower Incidence ◽

Control Group ◽

Postoperative Sore Throat ◽

Dexamethasone Group ◽

Significant Difference ◽

And Control

Background: Postoperative sore throat (POST) though a minor sequel after general anaesthesia with endotracheal intubation, it can be distressing to the patient.Objective: The effectiveness of lubricating endotracheal tube with 0.05% betamethasone gel or intravenous dexamethasone in reducing the postoperative sore throat was compared.Materials and method: This was a prospective study carried out among ninety ASA I and II informed consenting patients aged 20-50 years undergoing elective surgery under general anaesthesia with endotracheal intubation. The patients were randomly divided into three groups with thirty subjects in each group. Betamethasone gel (0.05%) was applied over endotracheal tube over 15 cm mark from the tip in group I, intravenous dexamethasone was given in group II and group III was taken as control. In post-anaesthesia care unit, an anesthesiologist interviewed all patients on postoperative sore throat at 1 hour, 6 hours and 24 hours after operation.Results: At 24 hours following extubation, there was statistically significant lower incidence of post-operative sore throat (POST) in betamethasone group compared to other two groups (betamethasone group 3.33%, dexamethasone group 20% and control group 26.66%, p<0.05). When the groups were compared in pairs at 24 hours, there was statistically significant difference in the incidence of POST between betamethasone group and dexamethasone group and also betamethasone group and control group with lower incidence of POST in betamethasone group, p<0.05. It was also observed that there was no significant difference of POST between dexamethasone and control group at 1 hour, 6 hours or 24 hours, p>0.05.Conclusion: It can be concluded that the use of 0.05% betamethasone gel to lubricate widely the endotracheal tube prior to intubation effectively reduces postoperative sore throat, compared to intravenous dexamethasone administration.Delta Med Col J. Jan 2018 6(2): 73-77

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POSTOPERATIVE NAUSEA AND VOMITING (PONV)

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.03.2476 ◽

2010 ◽

Vol 17 (03) ◽

pp. 394-399

Author(s):

ZULFIQAR ALI ◽

TANVEER AHMAD ◽

IRSHAD AHMAD ◽

A G Rehan

Keyword(s):

Placebo Group ◽

Postoperative Period ◽

Normal Saline ◽

Postoperative Nausea And Vomiting ◽

Complete Response ◽

Chi Square ◽

Dexamethasone Group ◽

Group I ◽

Chi Square Test ◽

Group Ii

Objective: To evaluate the effect of preoperative single dose injection dexamethasone for prevention of PONV in patients undergoing laparoscopic cholecystectomy and comparing it with normal saline (placebo). Design: Experimental RCT study. Place and duration of study: The study was conducted at Madina Teaching hospital, University Medical & Dental College, Faisalabad from January, 2008 to October 2009. Materials and Methods: After approval from the hospital ethical committee, 200 patients with ASA I & II were included in the study. We divided the patients into two groups; group I received preoperative dexamethasone (8mg) and the group II received normal saline (placebo) 90 minutes before the surgery. Patients were observed for any episodes of nausea or vomiting, need for rescue antiemetics, and complete responses in the postoperative period. The complete response was defined as no nausea, no vomiting, and no ant emetic medicationduring a 24-h postoperative period. This was also the primary efficacy end point of the study. The data was analyzed using Pearson’s Chi square test with P < 0.05 taken as significant. Results: Nineteen patients (19%) in the dexamethasone group reported nausea, compared with 43 (43%) in placebo group (p<0.05). Eight patients (8%) in the dexamethasone group reported vomiting and twenty two patients (22%) in theplacebo group reported vomiting (P <0.05). In group I, thirteen patients (13%) asked for rescue anti-emetic where as in group II (placebo group) thirty six patients (36%) asked for rescue anti-emetic (p<0.05). Seventy three patients (73%) in the dexamethasone group showed a complete response, compared with 35 (35%) in placebo group (p<0.05). Conclusion: We concluded that preoperative dexamethasone (8mg) reducesthe incidence of PONV as compared to placebo. As it is a cheap, freely available drug causing no complications, it should be used in otherwise fit selected patients undergoing laparoscopic cholecystctomy.

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Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study

Anesthesia and Pain Medicine ◽

10.17085/apm.20082 ◽

2021 ◽

Author(s):

Chan Jong Chung ◽

Seong Yeop Jeong ◽

Joon Ho Jeong ◽

Sung Wan Kim ◽

Kyung Hyun Lee ◽

...

Keyword(s):

Tracheal Intubation ◽

Sore Throat ◽

Normal Saline ◽

Rating Scale ◽

Double Lumen Tube ◽

Controlled Study ◽

Postoperative Sore Throat ◽

Double Lumen ◽

Double Blind ◽

Oropharyngeal Cavity

Background: Sore throat and hoarseness frequently occur following general anesthesia with tracheal intubation and are effectively reduced when dexamethasone is used prophylactically. Alchemilla vulgaris in glycerine (Neo Mucosal Activator®) suppresses inflammatory response, possibly relieving sore throat.Methods: We enrolled 94 patients (age ≥ 18 years) scheduled for thoracic surgery using double-lumen tube intubation. Before intubation, 0.2 mg/kg of dexamethasone was administered intravenously and 2 ml of normal saline was sprayed into the oropharyngeal cavity (Group D; n = 45), or 0.04 ml/kg normal saline was administered intravenously and 1 g of Neo Mucosal Activator® mixed with 1 ml of normal saline was sprayed into the oropharyngeal cavity (Group N; n = 43), in a double blind and prospectively randomized manner. Postoperative sore throat and hoarseness were recorded using a numeral rating scale and a 4-point scale to detect a change in voice quality following tracheal extubation (at 1, 6, and 24 h). The primary outcome was the incidence of sore throat at 24 h following surgery. The secondary outcomes were incidence and severity of sore throat and hoarseness.Results: There were no significant differences in the incidence of sore throat at 24 h following surgery (57.8% vs. 46.5%; P = 0.290) or in the incidence and intensity of sore throat and hoarseness at 1, 6, and 24 h following surgery between the groups. Conclusions: A. vulgaris in glycerine did not significantly differ from dexamethasone for preventing sore throat and hoarseness owing to intubation.

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Comparison of Intravenous Magnesium Sulphate and Lidocaine Effects on Attenuating Haemodynamic Variables to Laryngoscopy and Intubation in Patient Undergoing General Anesthesia

Esculapio ◽

10.51273/esc21.2517113 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Muhammad Azam ◽

Muhammad Wasim Ali Amjad ◽

Saadia Khaleeq ◽

Naila Asad

Keyword(s):

General Anesthesia ◽

Normal Saline ◽

Magnesium Sulphate ◽

Haemodynamic Response ◽

Controlled Study ◽

Intravenous Magnesium ◽

Significant Difference ◽

Blood Pressures ◽

Randomized Control ◽

Post Intubation

Objective: To determine the effect of intravenous xylocaine and magnesium sulfate on attenuation of hemodynamic response to laryngoscopy and intubation in patients undergoing general anaesthesia. Methods: This was a randomized controlled study carried out at operation theaters of services hospital lahore after obtaining approval from IRB of hospital. The data was collected over period of six month from 20.05.2020 to 20.12.2020 through electronic databases. 60 patients were divided into two groups of 30 each by lottery method in this randomized control trial. Intravenous magnesium sulphate 30 mg/ kg diluted in 50 ml normal saline 15 min before induction was administered in M group and 50 ml normal saline given in L group. Induction was done with propofol 2 mg/ kg, followed by suxamethonium 2 mg/ kg. I/V lignocaine 1.5 mg/kg diluted in N/S (5ml) was given as bolus in L group and 5 ml N/S IV bolus in M group 1 minute before intubation. Laryngoscopy was performed and the trachea was intubated after 1 minute. HR, systolic (SBP), diastolic (DBP) and mean arterial pressures (MAP) were measured just before securing intravenous access, just before induction, after intubation and 1,3,5 min post intubation. Results: Mean age for both groups was 36.0±12.8 and 38.2±10.8. Mean HR was significantly different between two groups immediately after intubation (p=0.010), and at 1, 3 and 5 minutes also (p=0.004, p=0.018 and p=0.024) respectively. No significant difference was seen in systolic, diastolic and mean blood pressures at intubation, 1 minute, 3 minutes and 5 minutes after intubation among the groups (p>0.05). Conclusion: Both Magnesian Sulfate and lignocaine are effective in attenuating haemodynamic response to laryngoscopy and intubation but magnesium sulphate provides better efficacy in control of heart rate. Key Words: Haemodynamic response, laryngoscopy, Intubation, magnesium sulphate, lignocaine. How to cite: Azam M., Amjad A.W.M., A. Khaleeq S., Asad N. Comparison of Intravenous Magnesium Sulphate and Lidocaine effects on attenuating haemodynamic variables to laryngoscopy and intubation in patient undergoing general anesthesia. Esculapio 2021; 17(01):65-70 DOI

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Effect of dexamethasone gargle, intravenous dexamethasone, and their combination on postoperative sore throat: a randomized controlled trial

Anesthesia and Pain Medicine ◽

10.17085/apm.20057 ◽

2020 ◽

Vol 15 (4) ◽

pp. 441-450

Author(s):

Seunghee Ki ◽

Inwook Myoung ◽

Soonho Cheong ◽

Sehun Lim ◽

Kwangrae Cho ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Sore Throat ◽

Intravenous Injection ◽

Normal Saline ◽

Controlled Trial ◽

Postoperative Sore Throat ◽

General Anesthesia Group ◽

Group I ◽

Total Incidence ◽

Postoperative Complaints

Background: Postoperative sore throat (POST) is a complication that decreases patient satisfaction and increases postoperative complaints. The present study was conducted to investigate effects of gargling with dexamethasone, intravenous dexamethasone injection and the combination of the two on the incidence and severity of POST.Methods: Study participants were 96 patients who had undergone laparoscopic cholecystectomy, randomly allocated into three groups. Group G gargled with 0.05% dexamethasone solution and were infused intravenous 0.9% normal saline before general anesthesia; group I gargled with 0.9% normal saline and were infused intravenous 0.1 mg/kg dexamethasone; group GI gargled with 0.05% dexamethasone solution and were infused intravenous 0.1 mg/kg dexamethasone. The incidence and severity of POST, hoarseness and cough were evaluated and recorded at 1, 6, and 24 h after the surgery.Results: There were no significant differences in the total incidence of POST up to 24 postoperative hours among Group G, Group I and Group GI (P = 0.367, Group G incidence = 34.38%, [95% confidence interval, 95% CI = 17.92–50.83], Group I incidence = 18.75%, [95% CI = 5.23–32.27], Group GI incidence = 28.13%, [95% CI = 12.55–43.70]). The other outcomes were comparable among the groups.Conclusions: In patients who had undergone laparoscopic cholecystectomy, gargling with 0.05% dexamethasone solution demonstrated the same POST prevention effect as intravenous injection of 0.1 mg/kg dexamethasone. The incidence and severity of POST were not significantly different between the combination of gargling with 0.05% dexamethasone solution and intravenous injection of 0.1 mg/kg dexamethasone and use of each of the preventive methods alone.

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