Betamethasone Gel versus Intravenous Dexamethasone as Prophylaxis against Postoperative Sore Throat

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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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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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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Assessment of endotracheal intubation procedures following inadvertent esophageal intubation. A randomized crossover manikin trial

Journal of the Pakistan Medical Association ◽

10.47391/jpma.814 ◽

2020 ◽

pp. 1-19

Author(s):

Sedat Bilge ◽

Yahya Ayhan Acar ◽

Attila Aydin ◽

Onur Tezel ◽

Guclu Aydin

Keyword(s):

Endotracheal Tube ◽

Endotracheal Intubation ◽

Completion Time ◽

Standard Procedure ◽

Video Laryngoscope ◽

Control Group ◽

Significant Difference ◽

Rate Of Success ◽

And Control ◽

Oesophageal Intubation

Abstract Objective: To evaluate the success, degree of difficulty and completion time of endotracheal intubation without removing the endotracheal tube in the event of an oesophageal intubation. Methods: The prospective, randomised crossover study was conducted at Gulhane Training and Research Hospital, Ankara, Turkey, from July 1, 2018, to August 31, 2018, and used a manikin model. Endotracheal intubation was performed using Miller, Macintosh blades and a video laryngoscope. The procedures were randomised into two groups, with group E+ being subjected to it while an endotracheal tube ETT was placed in the oesophagus (E+) simulating the oesophageal intubation, and control group E- getting the standard procedure without the endotracheal tube in the oesophagus. All methods were evaluated for their success, completion time, and degree of difficulty. Data was analysed using SPSS 22. Results: There were 120 manikins, with 60(50%) in each of the two groups. The mean completion time with Miller in E+ group was 19.05±9.65 and for E- it was 17.55±11.95 seconds. With Macintosh, E+ had a mean completion time of 19.85±12.66 seconds and E- had 16.75±8.66. With video laryngoscope, E+ group had a mean completion time of 16.75±8.66 seconds, while E- had it 14.60±8.17. No significant difference was found in the paired group comparisons in terms of the degree of task difficulty (p>0.05). Conclusion: In case of inadvertent oesophageal intubation condition, leaving the tube in the oesophagus and performing subsequent endotracheal intubation attempts was not found to decrease the rate of success regardless of the laryngoscope type. Continuous…

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Antibacterial Properties and Application of Nanosilver Material in the Tracheal Tube

Journal of Nanoscience and Nanotechnology ◽

10.1166/jnn.2020.18520 ◽

2020 ◽

Vol 20 (10) ◽

pp. 6542-6546

Author(s):

Yunjie Hu ◽

Xiaobei Ji ◽

Dunshuang Wei ◽

Jun Deng

Keyword(s):

Endotracheal Tube ◽

Endotracheal Intubation ◽

Tracheal Tube ◽

Antibacterial Properties ◽

Plate Count ◽

Control Group ◽

Significant Difference ◽

New Type ◽

Experimental Group

To investigate the antibacterial ability of a new type of antibacterial tracheal tube coated with nanosilver/polyurethane in rats. In January 2016, 48 male SD rats of SPF grade, provided by the medical center of Hong Kong University of science and technology, Peking University, Shenzhen, were selected as the study objects. Twenty-four healthy rats, who underwent endotracheal intubation and retained nanosilver/polyurethane-coated new antibacterial endotracheal tube in vivo, were randomly selected as the experimental group, while 24 healthy rats who underwent endotracheal intubation at the same time and retained common endotracheal tube in vivo were randomly selected as the control group. At 12, 24, 48, and 72 hours after the operation, the number of colonies in the alveolar lavage fluid of the two groups was measured using the plate count method, and the thickness of the biofilm formed by the built-in catheter of the two groups was observed by microscope. Twelve hours after operation, there was no significant difference between the two groups (P <0.05). The colony number in BALF in the experimental group was significantly lower than that in the control group (P < 0.05). At 12 and 24 hours after operation, there was no significant difference in the biofilm thickness between the two groups (P > 0.05). In the experimental group, the thickness of biofilm that had formed by catheterization 48 and 72 hours after operation was significantly lower than that in the control group (P < 0.05). The new type of antibacterial tracheal tube, coated with nanosilver/polyurethane, has stronger antibacterial and anti-biofilm proliferation performance than that of the common tracheal tube.

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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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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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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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A Comparison of Effectiveness f Betamethasone Gel and Lignocaine Jelly Applied to Tracheal Tube on Postoperative Sore Throat

Faridpur Medical College Journal ◽

10.3329/fmcj.v13i2.43621 ◽

2019 ◽

Vol 13 (2) ◽

pp. 58-61

Author(s):

Muhammad Sazzad Hossain ◽

Lipika Sanjowal ◽

Md Afzalur Rahman ◽

Mamunur Rashid ◽

Mahiuddin Alamgir ◽

...

Keyword(s):

General Anesthesia ◽

Sore Throat ◽

Outer Surface ◽

Postoperative Period ◽

Lower Incidence ◽

Postoperative Sore Throat ◽

Significant Difference ◽

Airway Symptoms ◽

Group B ◽

Comparison Of Effectiveness

Post-operative airway symptoms specially postoperative sore throat (POST) can be troublesome to patients following an uneventful general anesthesia with endotracheal intubation. Ninety ASA I and II informed consenting patients aged 20-50 years were recruited and randomly allocated into three groups of 30 each. The outer surface of the tracheal tubes used in intubating patients were lubricated with 0.05% betamethasone gel for group B, 2% lignocaine jelly for group L from the distal tip of the tube to the 15 cm mark and group C without lubrication. The incidence and severity of sore throat was then assessed at 1 hour, 6 hours and 24 hours during postoperative period. At 24 hours following extubation, there was a statistically significant lower incidence of POST in group B compared to other two groups. (group B= 6.66% vs group L= 33.33% vs group C= 40%, p<0.05). When the groups were compared in pairs, there was a statistically significant difference of POST between groups B and L also groups B and C with lower incidence of POST in group B at 24 hours, p<0.05. Significant difference in incidence of POST was, however, not found when group C was compared with group L separately, at different time of interval, p>0.05. It could be concluded that 0.05% betamethasone gel applied widely over endotracheal tube effectively reduces postoperative sore throat in comparison with 2% lignocaine jelly application. Faridpur Med. Coll. J. Jul 2018;13(2): 58-61

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Efficacy of intracuff dexamethasone in reducing the incidence of post-operative sore throat: an original article

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191655 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1665

Author(s):

Reshma Sugathan ◽

Sumesh Raj

Keyword(s):

Endotracheal Tube ◽

General Anaesthesia ◽

Sore Throat ◽

Normal Saline ◽

Point Scale ◽

Postoperative Sore Throat ◽

Cuffed Endotracheal Tube ◽

Swallowing Assessment ◽

Group D

Background: Postoperative sore throat is the most common and most distressing complaint of patients after general anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff dexamethasone in reducing the incidence of this distressing postoperative symptom.Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal saline respectively. The cuff was prefilled with dexamethasone or normal saline one hour prior to intubation to allow time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs after surgery.Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients (8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of hoarseness of voice between the two groups.Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence of hoarseness of voice.

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Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients

Journal of International Medical Research ◽

10.1177/0300060516687227 ◽

2017 ◽

Vol 45 (2) ◽

pp. 744-752 ◽

Cited By ~ 11

Author(s):

Jin Young Lee ◽

Woo Seog Sim ◽

Eun Sung Kim ◽

Sangmin M Lee ◽

Duk Kyung Kim ◽

...

Keyword(s):

Risk Factors ◽

General Anaesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Characteristic Curve ◽

Univariate Analysis ◽

Intracuff Pressure ◽

Postoperative Sore Throat ◽

Korean Patients ◽

Elective Surgical Procedures

Objective To investigate the incidence of postoperative sore throat (POST) in Korean patients undergoing general anaesthesia with endotracheal intubation and to assess potential risk factors. Methods This prospective study enrolled patients who underwent all types of elective surgical procedures with endotracheal intubation and general anaesthesia. The patients were categorized into group S (those with a POST) or group N (those without a POST). The demographic, clinical and anaesthetic characteristics of each group were compared. Results This study enrolled 207 patients and the overall incidence of POST was 57.5% ( n = 119). Univariate analysis revealed that significantly more patients in group S had a cough at emergence and hoarseness in the postanaesthetic care unit compared with group N. Receiver operating characteristic curve analysis showed that an intracuff pressure ≥17 cmH2O was associated with POST. Multivariate analysis identified an intracuff pressure ≥17 cmH2O and cough at emergence as risk factors for POST. At emergence, as the intracuff pressure over ≥17 cmH2O increased, the incidence of hoarseness increased. Conclusions An intracuff pressure ≥17 cmH2O and a cough at emergence were risk factors for POST in Korean patients. Intracuff monitoring during anaesthesia and a smooth emergence are needed to prevent POST.

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