scholarly journals Effects of Ketamine Gargle for Post-operative Sore Throat, Hoarseness of Voice and Cough Under General Anaesthesia- A Randomised Control Study

Author(s):  
Dinesh Chauhan ◽  
Ankit Mankad ◽  
Jigisha Mehta ◽  
Tejash H Sharma

Introduction: Majority of the patient undergo endotracheal intubation for various time duration, when given general anaesthesia. Injury in airway mucosa or vocal cords due to endotracheal intubation can be a contributing factor. Ketamine without affecting local healing process has an anti-proinflammatory effect as it limits exacerbation of systemic inflammation. Aim: To study the role of ketamine gargles as a pharmacological measure in order to attenuate POST, HOV and cough followed by endotracheal intubation during surgeries under general anaesthesia. Materials and Methods: A randomised controlled study was carried out for a duration of 22 months from the institutional ethical committee (Study Approval No. SVIEC/ON/MEDI/BNPG18/D19046), on 50 patients of American Society of Anaesthesiologists (ASA) grade I and II. They were allocated into two groups of 25 patients. Group (K): ketamine 50 mg in 29 mL 0.9% normal saline and Group (C): 30 mL 0.9% normal saline. Patients were advised to gargle for 30 seconds just 5 minutes prior to induction of anaesthesia. Patients were intubated with appropriate size of the endotracheal tube and were extubated when fully awake and conscious. Pateints were shifted to postoperative ward and were kept in propped up position with oxygen. Pateints were assessed at 1,2,4,24 hours for incidence of POST, HOV and cough. Assessment was made as per the 4 point scale grading system. The statistical analysis was performed using unpaired t-test, p<0.05 considered statistically significant. Results: In terms of POST grading in both K and C groups p-value was statistically significant (p<0.05) at 1 and at 2 hours postoperatively. In terms of HOV, in group K voice quality issues were reduced till 24 hours, (p<0.05). In terms of cough, in group K there was a significant reduction in complaints of cough till 4 hours postoperatively, (p<0.05). Conclusion: Ketamine gargles is effective in attenuating POST and cough till 2 hours and HOV till 4 hours postoperatively in patients following endotracheal intubation.

2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat

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


Author(s):  
Shyamal Dasgupta ◽  
Anindya Das ◽  
Anurag Mallick ◽  
Chiranjit Ghosh

Introduction: Preeclampsia is a multisystem disorder affecting pregnancy after 20 weeks of gestation featured by hypertension and proteinuria. Magnesium Sulphate (MgSO4) has been used for 24 hours following delivery to prevent eclampsia in patients with severe preeclampsia. Aim: To determine the need to continue magnesium sulphate therapy 8 hours following delivery. Materials and Methods: The double blinded randomised controlled study was performed in the Department of Gynaecology and Obstetrics at R.G. Kar Medical College, Kolkata, West Bengal, India, from 1st July 2015 to 30th June 2016. Total 90 patients with severe preeclampsia were randomised in two group. In group A MgSO4 was discontinued 8 hours following delivery (abbreviated group) and in the group B it was continued for 24 hours following delivery (traditional group). The primary objective of study was to determine the need to continue MgSO4 therapy 8 hours following delivery. Secondary objectives were monitoring time by doctors, nursing care time, postpartum ambulation time, duration of urinary catheterisation, minor complication like urinary tract infection, duration and total dose of MgSO4 therapy. In order to calculate statistical significance of the different variables in between two groups, Student’s independent sample’s t-test was used for normally distributed numerical values and Chi-square test or Fischer’s-exact test was used for unpaired proportion data. Results: In abbreviated group, the number of patients (n=1) who did not need to continue MgSO4 therapy beyond 8 hours following delivery as safety measures were statistically significant (p-value <0.0001) in comparison to traditional group. Total duration and dose of MgSO4 therapy were significantly less (p-value <0.0001) in the abbreviated group. There was statistically significant reduction in time from delivery to postpartum ambulation and duration of indwelling urinary catheter in the abbreviated group. Conclusion: The abbreviated (8 hours) regime of postpartum MgSO4 for seizure prophylaxis is a suitable alternative to the traditional (24 hours) regime.


2020 ◽  
pp. 1-6
Author(s):  
Surendra Kumar Raikwar ◽  
Anil Kori* ◽  
Aditya Agarwal

Tracheal extubation is the translaryngeal removal of a tube from the trachea via the nose or mouth and associated with awakening, pain, anxiety, airway irritation which may cause a cough or difculties in breathing and may contribute to an increase in haemodynamic response (1) .Several modalities, both pharmacological and nonpharmacological have been tried to decrease this stress response with variable success. We undertook this study to assess the efcacy of NTG spray in decreasing extubation related stress response in normotensive patients undergoing elective surgeries under general anaesthesia. Material and methods : Sixty normotensive patients were included in study and randomly subdivided into two groups of 30 patients each – group N receiving NTG spray and Group C not receiving NTG spray prior to extubation. Hemodynamic stress response during extubation was noted in both the groups and compared. Result and conclusion : Extubation was associated with signicant rise in systolic, diastolic and mean arterial blood pressure and heart rate in both the groups, but this stress response was signicantly less in NTG Group as compared to control group.


2019 ◽  
Vol 6 (3) ◽  
pp. 833
Author(s):  
Shahnaz Ahmad Sheikh ◽  
Aabid Hussain Mir ◽  
Abida Yousuf ◽  
Imtiaz Ahmad Naqash

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.


2019 ◽  
Vol 90 (4) ◽  
pp. 451-457 ◽  
Author(s):  
Ryuji Kaji ◽  
Takashi Imai ◽  
Yasuo Iwasaki ◽  
Koichi Okamoto ◽  
Masanori Nakagawa ◽  
...  

ObjectiveTo evaluate the efficacy and safety of intramuscular ultra-high-dose methylcobalamin in patients with amyotrophic lateral sclerosis (ALS).Methods373 patients with ALS (El Escorial definite or probable; laboratory-supported probable; duration ≤36 months) were randomly assigned to placebo, 25 mg or 50 mg of methylcobalamin groups. The primary endpoints were the time interval to primary events (death or full ventilation support) and changes in the Revised ALS Functional Rating Scale (ALSFRS-R) score from baseline to week 182. Efficacy was also evaluated using post-hoc analyses in patients diagnosed early (entered ≤12 months after symptom onset).ResultsNo significant differences were detected in either primary endpoint (minimal p value=0.087). However, post-hoc analyses of methylcobalamin-treated patients diagnosed and entered early (≤12 months’ duration) showed longer time intervals to the primary event (p<0.025) and less decreases in the ALSFRS-R score (p<0.025) than the placebo group. The incidence of treatment-related adverse events was similar and low in all groups.ConclusionAlthough ultra-high-dose methylcobalamin did not show significant efficacy in the whole cohort, this treatment may prolong survival and retard symptomatic progression without major side effects if started early.Trial registration numberNCT00444613.


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