Betamethasone Versus Ketamine for Attenuation of POST in Patients Undergoing Surgeries Under GA with Endotracheal Intubation- A Clinical Study

Background: Postoperative sore throat is one of the most common complications after endotracheal intubation. The present study was conducted to assess the role of betamethasone gel applied over the endotracheal tube cuff for attenuation of POST in patients undergoing surgeries under GA with endotracheal intubation and compare it with ketamine nebulization. Subjects and Methods : This is a randomized controlled prospective study conducted in 90 patients of either sex between 18-70 years of age divided into three groups. Group I patients received ketamine 50 mg, group II received 3 ml of water soluble 0.05% betamethasone gel, group III received 3 ml of water soluble 2% lignocaine. POST was graded on a four-point scale (0–3); 0 = no sore throat; 1 = mild sore throat (complains of sore throat only on questioning); 2 = moderate sore throat (complains of sore throat on his/her own); 3 = severe sore throat (change of voice or hoarseness, associated with severe throat pain). Results: The mean duration of surgery in group I was 128.5 minutes, in group II was 131 minutes and in group III was 134.5 minutes. There were 6 (20%), 7 (23.3) and 14 (46.6%) cases in group I, II and III respectively. The difference was significant (P< 0.05). At 0 hour there were 3 cases in group I, II and 10 in group III, at 2 hours was 3, 5 and 12 in group I, II and III respectively, at 6 hours was 5,4 and 14 cases in group I, II and III respectively, at 12 hours was 3, 3 and 12 cases in group I, II and III respectively and at 24 hours was 2, 2 and 12 cases in group I, II and III respectively. Conclusion: Authors found that POST can be equally managed with nebulisation with ketamine preoperatively and application of betamethasone gel over endotracheal tube cuff.

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Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation

Anesthesia & Analgesia ◽

10.1213/ane.0000000000001933 ◽

2017 ◽

Vol 125 (4) ◽

pp. 1240-1245 ◽

Cited By ~ 7

Author(s):

Jee-Eun Chang ◽

Hyerim Kim ◽

Sung-Hee Han ◽

Jung-Man Lee ◽

Sanghwan Ji ◽

...

Keyword(s):

Endotracheal Tube ◽

Sore Throat ◽

Endotracheal Intubation ◽

Endotracheal Tube Cuff ◽

Postoperative Sore Throat ◽

Tube Cuff

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Lidocaine as Endotracheal Tube Cuff Inflating Agent

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v5i1.2847 ◽

1970 ◽

Vol 5 (1) ◽

pp. 25-28

Author(s):

Nadeem Parvez Ali ◽

Md Tauhid-ul-Mulck ◽

Mahbub Noor ◽

Md Torab Mollick ◽

Masud Ahmed ◽

...

Keyword(s):

Endotracheal Tube ◽

Sore Throat ◽

Distilled Water ◽

Endotracheal Tube Cuff ◽

Postoperative Sore Throat ◽

Lidocaine Group ◽

Entire Study ◽

Tube Cuff ◽

Water Group ◽

A Prospective Study

A prospective study was carried on 120 patients undergoing surgical operations lasting less than 90 minutes. The incidence of postoperative sore throat, dysphasia and hoarseness of voice with 2% lidocaine (Group L) as endotracheal cuff inflating agent was compared with that with distilled water (Group D) and air (Group A). Seventy two percent of lidocaine group in comparison to 60% distilled water group and 37% air group experienced none of the above complications during the entire study period. Only 5% in lidocaine group had sore throat after 22-24 hours compared to 20% in the distilled water group and 45% in the air group. Twenty three percent complained of dysphasia in both lidocaine and distilled water group after 1-3 hours compared to 45% in air group. After 22-24 hours it completely resolved in lidocaine group compared to 20% persisting in the other two groups. Twenty three percent complained of hoarseness in lidocaine group as compared to 35% and 55% in distilled water and air groups respectively after 1-3 hours. This completely resolved in lidocaine group but persisted in 20% and 45% in the distilled water and air group respectively after 22-24 hours. The results showed an advantage in using lidocaine as an endotracheal tube cuff inflating agent in reducing postoperative sore throat, dysphasia and hoarseness in comparison to distilled water and air. Key Words: Lidocain, Endotracheal tube (ETT) cuff inflating agent. doi: 10.3329/jafmc.v5i1.2847 JAFMC Bangladesh. Vol 5, No 1 (June) 2009 pp.25-28

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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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The effect of endotracheal tube cuff pressure change during gynecological laparoscopic surgery on postoperative sore throat: a control study

Journal of Clinical Monitoring and Computing ◽

10.1007/s10877-014-9578-2 ◽

2014 ◽

Vol 29 (1) ◽

pp. 141-144 ◽

Cited By ~ 14

Author(s):

Guiqi Geng ◽

Jingyi Hu ◽

Shaoqiang Huang

Keyword(s):

Laparoscopic Surgery ◽

Endotracheal Tube ◽

Sore Throat ◽

Cuff Pressure ◽

Pressure Change ◽

Endotracheal Tube Cuff ◽

Postoperative Sore Throat ◽

Tube Cuff ◽

Endotracheal Tube Cuff Pressure ◽

Control Study

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Ultrasound compared to Age Related Formulas for prediction of Pediatric Endotracheal Tube Size

QJM ◽

10.1093/qjmed/hcaa039 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A Abdelghany ◽

N Nasr ◽

S Talaat ◽

M Mansour ◽

T Shabana

Keyword(s):

Endotracheal Tube ◽

Airway Pressure ◽

Ultrasound Measurement ◽

Outer Diameter ◽

Transverse Diameter ◽

Tube Size ◽

Group Iii ◽

Age Related ◽

Group I ◽

Group Ii

Abstract Background In pediatric patients, having proper size of endotracheal tube (ETT) is crucial. The practice of using age-based formulas to calculate the ETT size is easy, practical and commonly used today. However, the incidence of inappropriate tube size is still judicious, hence increasing risk from changing tube such as trauma and aspiration. Recent studies found that measuring the narrowest transverse subglottic diameter may guide the proper tube size Aim This study was aimed to proof that selecting ETT size using ultrasound measurement of subglottic diameter is a reliable method and lead to less frequency of changing tube size than age-based formula especially in older children Materials and Methods 60 children aged between 2 to 12 years, of both genders, American society of anesthesiologists (ASA) I or II physical status scheduled for day case surgery under general endotracheal anesthesia. Children were divided randomly according to age into three groups: group I included children aged between 2 to < 5 years, group II included children aged between 5 to < 9 years, and group III included children aged between 9 to 12 years. In all childern, the size of the ETT was determined according to both ultrasonography and modified cole's formula. The size of the ETT initially inserted was based on ultrasonographic calculation. Ultrasonography is done using high–resolution linear ultrasound probe. The probe was positioned at the anterior aspect of neck in the midline with the head extended and neck flexed (sniffing position). The minimal transverse diameter of the subglottic airway (MTDSA) was estimated at the level of cricoid cartilage at zero cmH2O airway pressure. After measurement of the subglottic diameter, uncuffed ETT with the nearest outer diameter (OD) corresponding to the measured subglottic diameter was selected for intubation. If there was resistance to ETT passage into the trachea, or there was no audible leak when the lungs were inflated to a pressure of 20–30 cm H2O, the tube was exchanged with one that is 0.5 mm smaller. In contrast, the ETT was exchanged for one that is 0.5 mm larger if leaks occurred at an inflation pressure less than 10 cm H2O. Optimal tube size was clinically determined by leakage at airway pressure of 10-20 cmH2O. Results Linear correlation study showed that Ultrasonography was a better predictor for optimal ETT size in pediatrics than Cole's formula for all studied groups especially in older age groups (although both were significant); being 0.669 Vs. 0.613 among group I; 0.955 Vs. 0.808 among group II and 0.863 Vs. 0.707 among group III. Multi-regression analysis showed that both Ultrasonography & Cole's formula were highly sensitive independent predictors that can predict Optimal ETT size in pediatrics (F-Ratio = 524.7, p < 0.001); The prediction formula is: Optimal ETT size ID = -0.091 + 0.814(ID obtained by US) + 0.192(ID obtained by Cole's formula). Conclusion Ultrasound is a safe, reliable, non-invasive tool for selection of appropriately sized endotracheal tube for clinical use. Our study validates the reliability of ultrasound to measure subglottic diameter which avoids intubation related complications of either trauma or inefficient ventilation.

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