scholarly journals Comparison of Ketamine Nebulisation with Ketamine Gargle in Attenuating Post Operative Sore Throat Following General Anaesthesia with Endotracheal Intubation

2021 ◽  
pp. 129-136
Author(s):  
Anjali Modak ◽  
Eshana Rasheed ◽  
Nikhil Bhalerao ◽  
Pallavi Devulkar
Keyword(s):  
Tracheal Intubation ◽  
General Anaesthesia ◽  
Sore Throat ◽  
Normal Saline ◽  
Statistical Difference ◽  
Elective Surgery ◽  
Randomized Study ◽  
Point Scale ◽  
Post Operative Period ◽  
Preservative Free

Background & Objective: In the post operative period, Sore throat is a common morbidity following tracheal intubation. The aim was to compare ketamine nebulisation with ketamine gargle to see the effectiveness of nebulisation over gargle in reducing the incidence and severity of post operative sore throat (POST). Methods: In this prospective, randomized study 80 patients between 18-64 year, of either sex belonging to ASA I/II, scheduled for elective surgery under general anaesthesia, were assigned into two groups of 40 patients each. Group GK received preservative free ketamine 50mg in 29 ml of saline, gargled for 30 seconds and Group NK received ketamine 50 mg in 4ml of normal saline via nebulisation for 15 min. General anaesthesia was induced 5 min later in both the groups. Postoperatively sore throat was assessed at 0, 2, 4, 24 hrs using four point scale (0-3). Results: The incidence of POST at 0, 2, 4, 24 hrs was 27%, 25%, 20% and 17% respectively in GK group and 20%, 17.5%, 12.5% and 7.5% in NK group respectively with no statistical difference between the two.. None of the patients in either group experienced severe sore throat. Conclusion: Ketamine nebulisation seemed to represent an effective alternative to ketamine gargle for reliving Post Operative sore throat.

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

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.

scholarly journals Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study

2020 ◽  
Author(s):  
Yuanyuan Ma ◽  
Yan Wang ◽  
Ping Shi ◽  
Xue Cao ◽  
Shengjin Ge
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Sore Throat ◽  
Elective Surgery ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Intubation Attempt ◽  
Successful Intubation ◽  
Ultrasound Guided ◽  
Normal Airway

Abstract Background To compare ultrasound-guided tracheal intubation (UGTI) versus Shikani optical stylet (SOS)-aided tracheal intubation in patients with anticipated normal airway.Methods Sixty patients aged 18–65 years old who presented for elective surgery under general anesthesia were recruited in this prospective randomized study. They were assigned into two equal groups, either an ultrasound-guided group (Group UG, n = 30) or an SOS-aided group (Group SOS, n = 30). After the induction of anesthesia, the tracheal intubation was performed by a specified skilled anesthesiologist. The number of tracheal intubation attempt and the duration of successful intubation on the first attempt were recorded. Complications relative to tracheal intubation including desaturation, hoarseness and sore throat were also recorded.Results The first-attempt success rate is 93.3% (28/30) in Group UG and 90% (27/30) in Group SOS (P = 0.64). The second-attempt was all successful for the 2 and 3 patients left in the two groups, and the overall success rate of both groups was 100%. The duration of successful intubation on the first attempt of Group UG was not significantly different from that of Group SOS (34.0 ± 20.8 s vs 35.5 ± 23.2 s, P = 0.784). One patient in Group SOS had desaturation (P = 0.313), and there was none hoarseness in the two groups. Sore throat was detected in both group (4 in Group UG, 5 in Group SOS, P = 0.718).Conclusion Ultrasound-guided tracheal intubation was as effective as Shikani optical stylet-aided tracheal intubation in adult patients with anticipated normal airway.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IIC-17010875. Date of Registration: 15 March 2017.

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

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.

scholarly journals Prevalensi Nyeri Tenggorok Pascaoperasi dengan Pemberian Lubrikasi VCO pada Pemasangan LMA

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Rahmadhya Khairina Rianti
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anaesthesia ◽  
Sore Throat ◽  
Elective Surgery ◽  
Coconut Oil ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Virgin Coconut Oil ◽  
Postoperative Sore Throat ◽  
Post Operative Period

Background. Postoperative sore throat (POST) is a common complication after general anaesthesia. It affects patient satisfaction and can affect activity after discharge. The supraglottic airway device (SAD) offers an alternative to traditional tracheal intubation with potential benefit in preventing sore throat. Numerous agents have been used as lubricant to reduce the incidence of POST with variable efficacy. The purpose of this study is to determine the prevalence of postoperative sore throat in patients with Virgin Coconut Oil (VCO) as a lubricant for Laryngeal Mask Airway (LMA) insertion in patients undergoing general anaesthesia for elective surgery. Objective. Determine the prevalence of postoperative sore throat in patients by giving Virgin Coconut Oil (VCO) as a lubricant for the Laryngeal Mask Airway (LMA) installation under general anesthesia for elective surgery. Methods. This is an observational descriptive study, was conducted in December 2019 until June 2020 at Surgical Installation RSUP dr. M. Djamil Padang and Andalas University Hospital. Forty-two subjects were recruited to this study taken by using consecutive sampling technique. Results. Patients evaluated about sore throat at immediately, 2 hours, and 24 hours post-operative period. POST was observed in 47,6% of the patients in immediate post-operative period. After 2 hours 23,8% patients had sore-throat, and after 24 hours 9,5% patients had sore-throat. Among patients had sore throat after 24 hours, the intensity was mild. Conclusion. We conclude that lubricating cuff of LMA with VCO can reduce the prevalence of POST. Keyword: Laryngeal Mask Airway, sore throat, Virgin Coconut Oil

scholarly journals Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study

2020 ◽  
Author(s):  
Yuanyuan Ma ◽  
Yan Wang ◽  
Ping Shi ◽  
Xue Cao ◽  
Shengjin Ge
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Sore Throat ◽  
Elective Surgery ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Intubation Attempt ◽  
Successful Intubation ◽  
Ultrasound Guided ◽  
Normal Airway

Abstract Background: To compare ultrasound-guided tracheal intubation (UGTI) versus Shikani optical stylet (SOS)-aided tracheal intubation in patients with anticipated normal airway.Methods: Sixty patients aged 18-65 years old who presented for elective surgery under general anesthesia were recruited in this prospective randomized study. They were assigned into two equal groups, either an ultrasound-guided group (Group UG, n=30) or an SOS-aided group (Group SOS, n=30). After the induction of anesthesia, the tracheal intubation was performed by a specified skilled anesthesiologist. The number of tracheal intubation attempt and the duration of successful intubation on the first attempt were recorded. Complications relative to tracheal intubation including desaturation, hoarseness and sore throat were also recorded.Results: The first-attempt success rate is 93.3% (28/30) in Group UG and 90% (27/30) in Group SOS (P=0.640). The second-attempt was all successful for the 2 and 3 patients left in the two groups, and the overall success rate of both groups was 100%. The duration of successful intubation on the first attempt of Group UG was not significantly different from that of Group SOS (34.0±20.8s vs 35.5±23.2s, P=0.784). One patient in Group SOS had desaturation (P=0.313), and there was none hoarseness in the two groups. Sore throat was detected in both group (4 in Group UG, 5 in Group SOS, P= 0.718).Conclusion: Ultrasound-guided tracheal intubation was as effective as Shikani optical stylet-aided tracheal intubation in adult patients with anticipated normal airway.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IIC-17010875. Date of Registration: 15 March 2017.

Comparison between Sniffing Position and 25 Degree Backup Position in View of Glottis During Direct Laryngoscopy and Intubation - A Study from Mangalore, Karnataka

2021 ◽  
Vol 8 (41) ◽  
pp. 3573-3577
Author(s):  
AKhil Rao U.K. ◽  
Athira Soman ◽  
Anuradha Yadav ◽  
Yashwant R. ◽  
Sucheth Sharat
Keyword(s):  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Randomized Study ◽  
Group I ◽  
Head Positioning ◽  
Difficulty Scale ◽  
Group Ii

BACKGROUND Endotracheal intubation for the purpose of providing anaesthesia was first described by William Mc Ewan. Jackson1 stressed the importance of anterior flexion of the lower cervical spine, in addition to obvious extension of the atlanto-occipital joint. Sniffing position has been commonly advocated as a standard head positioning for direct laryngoscopy which is achieved by flexion of the neck on chest and extension of the head at the atlanto-occipital joint. Present study was designed to evaluate the glottis view and ease of intubation achieved with direct laryngoscopy in the sniffing position with that of 25 degree backup position in a study group of 100 patients divided in 2 groups of 50 each. METHODS This study is a controlled comparative study. Controlled trial in 50 consecutive patients in each group [Group I and Group II] was conducted on patients who underwent elective surgery under general anaesthesia. Inclusion Criteria - General anaesthesia with endotracheal intubation, Aged 18 to 60 years, American society of Anaesthesiologists (ASA) grades I and II. Exclusion Criteria - Patients with body mass index more than 30 kg/m2. 1. Bucked teeth. 2. Restricted neck movement. 3. Inter-incisor gap less than 35 mm. 4. Thyro-mental distance less than 6 mm. 5. Patients with risk of regurgitation and aspiration. 6. Pharyngeal pathology. 7. Limitation of anterior and posterior movement of mandible 8. Pregnant patients Groups wereGroup I – Sniffing position Group II– 25 degree back up position RESULTS The glottis visualization was assessed by Cormack Lehane grading which revealed that glottis view was better in 25 degree backup position than sniffing position. CONCLUSIONS In our prospective randomized study in a series of 50 patients undergoing general anaesthesia in SIMS & RC, intubation difficulty scale (IDS) score was better in 25 degree backup position than sniffing position. It implies glottis view is better in 25 degree backup position than sniffing position. KEYWORDS Sniffing Position, 25 Degree Backup Position, Laryngoscopy

scholarly journals Sevoflurane at 1.0 MAC together with remifentanil and propofol produces clinically acceptable intubation conditions at the vocal cords: A prospective randomized study

2017 ◽  
Vol 45 (3) ◽  
pp. 1098-1108 ◽  
Author(s):  
Attila Ovari ◽  
Ilona Bicker ◽  
Susann Machmueller ◽  
Tobias Schuldt ◽  
Martin Sauer ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Tracheal Intubation ◽  
Vocal Cord ◽  
Sore Throat ◽  
Minimum Alveolar Concentration ◽  
Randomized Study ◽  
Trial Registration ◽  
Prospective Clinical Trial ◽  
Prospective Randomized Study ◽  
Vocal Cords

Objective The overall intubation conditions after tracheal intubation with remifentanil, propofol, and sevoflurane at 1.0 minimum alveolar concentration (MAC) are worse than with rocuronium at 0.45 mg/kg. Therefore, we compared the intubation conditions and laryngeal morbidity (vocal cord injuries, hoarseness, and sore throat) with sevoflurane at 1.2 and 1.4 MAC versus 1.0 MAC. Methods In this prospective clinical trial, 90 patients were randomized to 3 groups: the sevoflurane 1.0, 1.2, and 1.4 MAC groups. At 3 min, tracheal intubation was performed and the patients’ intubation conditions were assessed. The vocal cords were examined for injury by videolaryngoscopy. Additionally, the incidence and severity of laryngeal morbidity were compared between women and men. Results Acceptable intubation conditions were seen in 72% of the patients without significant differences between the groups. Overall, vocal cord injuries (oedema) occurred in three (4%) patients. Women reported sore throat more often than men (51% vs. 21%, respectively). Conclusions Intubation conditions were not improved with higher sevoflurane concentrations. The incidence and severity of sore throat were greater in women than men. Trial registration: ClinicalTrials.Gov: NCT 01896245

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

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.

scholarly journals 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

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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