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

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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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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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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Comparative study of prophylactic dexamethasone versus placebo for reducing post-operative sore throat after tracheal intubation: a prospective, randomised, double blinded clinical study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202899 ◽

2020 ◽

Vol 8 (7) ◽

pp. 2583

Author(s):

Neethu George ◽

Sumesh Mathew

Keyword(s):

Tracheal Intubation ◽

Sore Throat ◽

Normal Saline ◽

Randomized Study ◽

Saline Group ◽

Anesthesia Induction ◽

Elective Surgical Procedures ◽

Dexamethasone Group ◽

Long Acting ◽

Double Blinded

Background: Tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may account for postoperative sore throat, hoarseness and cough. Dexamethasone is a very potent long acting glucocorticoid with analgesic, anti-inflammatory and antiemetic effects which helps to reduce post-operative sore throat.Methods: A prospective double blinded randomized study was conducted involving 80 patients, dividing them into 2 groups. Group D received dexamethasone 0.1 mg/kg and group S received an equivalent volume of normal saline (placebo) intravenously before induction. Intubation was performed by an experienced anesthesiologist. Anesthesia induction and maintenance dosage were standardized for all patients. The incidence and severity of sore throat, hoarseness and cough were recorded at 1, 6 and 24 hours postoperatively by using four-point scale.Results: The overall incidence of sore throat and hoarseness was significantly reduced in dexamethasone group compared to placebo (normal saline) group. Incidence and severity of sore throat and hoarseness were assessed at 1 hour, 6 hours and 24 hours interval and found out that they were reduced in dexamethasone group compared to placebo group which was statistically significant at all intervals. But incidence and severity of cough reduced significantly only in the first hour. It was comparable at 6 and 24 hours between the groups.Conclusions: Dexamethasone was effective in reducing the incidence and severity of sore throat and hoarseness at 1, 6 and 24 hours. Incidence of postoperative cough was reduced significantly at 1 hour in the dexamethasone group.

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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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20192248 ◽

2019 ◽

Vol 6 (3) ◽

pp. 833

Author(s):

Shahnaz Ahmad Sheikh ◽

Aabid Hussain Mir ◽

Abida Yousuf ◽

Imtiaz Ahmad Naqash

Keyword(s):

Placebo Group ◽

Sore Throat ◽

Endotracheal Intubation ◽

Normal Saline ◽

Magnesium Sulphate ◽

Controlled Study ◽

Postoperative Sore Throat ◽

Dexamethasone Group ◽

Intravenous Magnesium ◽

Group I

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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Selective neuromodulation induced by alpha-based neurofeedback learning: A double-blind randomized study

10.1101/2020.12.02.406173 ◽

2020 ◽

Author(s):

Fanny Grosselin ◽

Audrey Breton ◽

Lydia Yahia-Cherif ◽

Xi Wang ◽

Giuseppe Spinelli ◽

...

Keyword(s):

Brain Activity ◽

Randomized Study ◽

Training Group ◽

Alpha Activity ◽

Controlled Study ◽

Control Group ◽

Double Blind Study ◽

List Type ◽

Double Blind ◽

Wearable Eeg

AbstractBackgroundThe neuromodulation induced by neurofeedback training (NFT) remains a matter of debate. Investigating the modulation of brain activity specifically associated with NF requires controlling for multiple factors, such as reward, performance, congruency between task and targeted brain activity. This can be achieved using sham feedback (FB) control condition, equating all aspects of the experiment but the closed-loop between brain activity and FB.ObjectiveWe aimed at investigating the modulation of individual alpha EEG activity induced by NFT in a double-blind, randomized, sham-controlled study.MethodsForty-eight healthy participants were assigned to either NF (n=25) or control (n=23) group and performed 12 NFT sessions of alpha upregulation with a wearable EEG device. Participants of the NF group received FB based on their individual alpha activity. The control group received the auditory FB of participants of the NF group.ResultsAn increase of alpha activity across training sessions was observed in the NF group only (p<0.001). This neuromodulation was selective in that it was not observed for theta (4-8Hz) and low beta (13-18Hz) activities. It was associated with an increased feeling of control (p<0.001), more marked for NF than control group. Anxiety level decreased and relaxation feeling increased with training in both groups.ConclusionsNFT across multiple sessions can induce specific brain modulation, suggesting a neuroplasticity selective of the targeted brain activity. Our results pave the way to self-learnt, NF-based neuromodulation with light-weighted, wearable EEG systems for various applications (e.g. epilepsy, sleep, attention).HighlightsRandomized double-blind study of neuromodulation induced by EEG-neurofeedback (NF)Sham feedback (FB) was used for the control groupTargeted alpha activity increased selectively over the 12 NF training sessionsThis neuromodulation was observed only in the real NF training groupThe feeling of control across sessions increased more for real than sham FB group

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Low-Dose Dexamethasone as an Adjuvant for Prolonging the Duration of Brachial Plexus Block with Bupivacaine—a Prospective Randomised Controlled Study

Caribbean Medical Journal ◽

10.48107/cmj2021.05.001 ◽

2021 ◽

Author(s):

Seetharaman Hariharan

Keyword(s):

Brachial Plexus ◽

Low Dose ◽

Controlled Trial ◽

Demographic Data ◽

Local Anaesthetics ◽

Controlled Study ◽

Control Group ◽

Double Blind ◽

Dexamethasone Group ◽

Duration Of Surgery

Objectives Dexamethasone, in the dose of 8 mg or higher, has been advocated to be used as an adjuvant to prolong the duration of brachial plexus blocks with local anaesthetics. This study aimed to test the hypothesis that a lower dose of dexamethasone (4 mg) added to bupivacaine would prolong the duration of analgesia in brachial plexus blocks. Methods A randomized double-blind placebo-controlled trial was conducted on patients who underwent supraclavicular brachial plexus blocks using an ultrasound. Patients were randomized to receive 19 mL of 0.5% bupivacaine with dexamethasone (4 mg) (study group) and saline (1 mL) (control group). Primary outcome measure was the duration of analgesia. Onset and duration of sensory, motor blocks, postoperative 24-hour morphine requirements were also recorded. Results A total of 46 patients were studied with 24 patients in the dexamethasone group and 22 patients in the control group. Demographic data, type and duration of surgery were comparable between the groups. Dexamethasone group patients had significantly longer duration of analgesia [Mean (SD): 19.8 (3.8) hours], compared to control group patients [Mean (SD): 14.5 (4.2); p< 0.001]. Morphine requirements over a 24-hour period were not significantly different between the groups. Conclusion Low-dose dexamethasone significantly prolongs the duration of analgesia when used with bupivacaine in supraclavicular brachial plexus blocks, although it does not significantly decrease the overall opioid requirements for 24 hours postoperatively.

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Influence of two-handed jaw thrust during tracheal intubation on postoperative sore throat: a prospective randomised study

Journal of International Medical Research ◽

10.1177/0300060520961237 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052096123

Author(s):

Hyub Huh ◽

Doo Yeon Go ◽

Jang Eun Cho ◽

Jihoon Park ◽

Jiwon Lee ◽

...

Keyword(s):

Tracheal Intubation ◽

General Anaesthesia ◽

Sore Throat ◽

Randomised Trial ◽

Control Group ◽

Single Centre ◽

Postoperative Sore Throat ◽

Double Blind ◽

Clinical Trial Registration ◽

Randomised Study

Objective General anaesthesia with tracheal intubation results in sore throat. We evaluated the influence of the two-handed jaw thrust on postoperative sore throat in patients who require tracheal intubation. Methods In this prospective, double-blind, single-centre, parallel-arm, and randomised trial, 92 patients who were scheduled for general anaesthesia for total hip arthroplasty were allocated to one of two groups. In the jaw thrust group (n = 46), the two-handed jaw thrust manoeuvre was applied at intubation. In the control group (n = 46), conventional intubation with sham jaw thrust was performed. Incidences of airway morbidities including sore throat, hoarseness, and cough at 2, 4, and 24 hours postoperatively were compared. Results During the postoperative 24 hours, the incidence of sore throat (8 [17%] vs. 20 [44%]) and hoarseness were lower in the jaw thrust group (8 [17%] vs. 18 [39%]) compared with the control group. The incidence of cough during the postoperative 24 hours was similar between the groups. Conclusions The jaw thrust manoeuvre significantly reduced sore throat and hoarseness in patients after general anaesthesia using tracheal intubation. Clinical trial registration: NCT 03568279.

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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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STUDY ON BETAMETHASONE GELAND LIGNOCAINE JELLY APPLIED OVER ENDOTRACHEAL TUBE TO REDUCE POST OPERATIVE SORE THROAT, COUGH ANDHOARSENESS OF VOICE

10.36106/0118319 ◽

2021 ◽

pp. 15-16

Author(s):

Stalin Ramamoorthy ◽

Muthukumar Thangaraj

Keyword(s):

Endotracheal Tube ◽

General Anaesthesia ◽

Sore Throat ◽

Orotracheal Intubation ◽

Control Group ◽

Postoperative Sore Throat ◽

Lidocaine Group ◽

Group B ◽

Anaesthesia Care ◽

And Control

Background and Objectives: Controlled comparison between 0.05% betamethasone gel, 2% lidocaine jelly, lubricating gel applied over endotracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice at 0,6,&24 hrs Materials And Methods: This study compares the incidence of postoperative sore throat, cough, and hoarseness ovoice after general anaesthesia when applying betamethasone gel (betamethasone group-B) or lidocaine jelly( lidocaine group -L) on the tracheal tube. 120 ASAclass I and II patients undergoing elective surgeries under general anaesthesia with orotracheal intubation were randomized into three groups: betamethasone gel, lidocaine jelly, and control groups (C group). In the post-anaesthesia care unit, all patients were interviewed on postoperative sore throat, cough, and hoarseness of voice at 0, 6, and 24 h after surgery. Results and Conclusion:Awide spread application of betamethasone gel (B) on the endotracheal tube decreases the incidence and severity of postoperative sore throat, cough, and hoarseness of voice as compared to lignocaine group(L) and control group (c).

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