Efficacy of intravenous dexamethasone to reduce incidence of postoperative sore throat: A prospective randomized controlled trial

Dipanjan Bagchi, Mohan Chandra Mandal, Sabyasachi Das, Tirtha Sahoo, Sekhar Ranjan Basu, Sanhita Sarkar, Dipanjan Bagchi, Mohan Chandra Mandal, Sabyasachi Das, Tirtha Sahoo, Sekhar Ranjan Basu, Sanhita Sarkar

Abstract

Background: Sore throat and hoarseness are common complications of endotracheal intubation. It may be very distressing for the patient and may lead to sleep disturbances and unpleasant memories.

Materials and methods: This prospective double-blinded randomized control trial was aimed to determine the efficacy of prophylactic intravenous dexamethasone to reduce the incidence of postoperative sore throat at 1 hour after tracheal extubation. Ninety six patients of either sex aged between 18 to 60 years scheduled for elective surgeries needing general anesthesia with endotracheal intubation, were randomly allocated into two groups A and B. The patients received either intravenous 0.2 mg/kg dexamethasone (group A, n = 48) or normal saline (group B, n = 47) just before induction. Trachea was intubated with appropriate size disposable endotracheal tubes for securing the airway. Follow up for the incidence of sore throat, cough and hoarseness was done at 1, 6 and 24 hours post-extubation.

Results: At 1 hour post-extubation, the incidence of sore throat in the control group was 48.9% compared with 18.8% in the dexamethasone group (P<0.002).

Conclusions: Prophylactic intravenous dexamethasone in a dose of 0.2 mg/kg can reduce the incidence of postoperative sore throat at 1 hour post-extubation by around 30%, with the efficacy being around 60%.

Keywords: Intravenous dexamethasone; Intubation; Postoperative sore throat.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Sumathi PA, Shenoy T, Ambareesha M, Krishna HM. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Anaesth. 2008;100:215–8.
    1. Maruyama K, Sakai H, Miyazawa H, Toda N, Iinuma Y, Mochizuki N, et al. Sore throat and hoarseness after total intravenous anaesthesia. Br J Anaesth. 2004;92:541–3.
    1. Park SH, Hang SH, Do SH, Kim JW, Rhee KY, Kim JH. Prophylactic dexamathasone decreases the incidence of sore throat and hoarseness after tracheal extubation with a double lumen endotracheal tube. Anesth Analg. 2008;107:1814–8.
    1. Ogata J, Minami K, Horishita T, Shirashi M, Okamoto T, Terada T, et al. Gargling with sodium azulene sulfonate reduces the postoperative sore throat after intubation of the trachea. Anesth Analg. 2005;101:290–3.
    1. Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U. Ketamine gargle for attenuating sore throat. Br J Anaesth. 2008;100:490–3.
    1. Alhashemi JA. Dexmedetomidine vs.midazolam for monitored anesthesia care during cataract surgery. Br J Anaesth. 2006;96:722–6.
    1. Scuderi PE. Postoperative sore throat: More answers than questions. Anesth Analg. 2010;111:831–2.
    1. Huang YS, Hung NK, Lee MS, Kuo CP, Yu JC, Huang GS, et al. The effectiveness of benzydamine hydrochloride spraying on the endotracheal tube cuff or oral mucosa for postoperative sore throat. Anesth Analg. 2010;111:887–91.
    1. Rudra A, Ray S, Chatterjee S, Ahmed A, Ghosh S. Gargling with ketamine attenuates the postoperative sore throat. Indian J Anaesth. 2009;53:40–3.
    1. Liu J, Zhang X, Gong W, Li S, Wang F, Fu S, et al. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: A multicenter study. Anesth Analg. 2010;111:1133–7.
    1. Goodwin JS, Atluru D, Sierakowski S, Lianos EA. Mechanism of action of glucocorticosteroids inhibition of T cell proliferation and Interleukin 2 production by hydrocortisone is reversed by Leukotriene B4. J Clin Invest. 1986;77:1244–50.
    1. Thomas S, Beevi S. Dexamethasone reduces the severity of postoperative sore throat. Can J Anaesth. 2007;54:897–901.
    1. Akhgar AA, Karvandian K, Rahimi FA, Akhgar F. Prevention of postextubation sore throat following general anesthesia by intravenous dexamethasone sore throat in questionnaire. J Iranian Soc Anesthesiol Intensive Care. 2008;30:65–72.
    1. Park SY, Kim SH, Lee AR, Cho SH, Chae WS, Jin HC, et al. Prophylactic effect of dexamethasone in reducing postoperative sore throat. Korean J Anesthesiol. 2010;58:15–9.
    1. Kumar V, Abbas AK, Fausto N, Aste JC, editors. Chapter 2, Acute and chronic inflammation. 8th ed. Philadelphia: Saunders Elsevier; 2010. [Last cited on 2012 January 22]. Robbins and Cotran Pathologic Basic of Disease. Available from: .

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