Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: A randomized controlled trial.
Brazilian journal of anesthesiology (Elsevier) – June 13, 2025
Source: PubMed
Summary
Filling endotracheal tube cuffs with dexamethasone instead of saline can significantly reduce throat pain and discomfort after surgery. In a study of 405 patients, those receiving dexamethasone experienced less coughing, hoarseness, and postoperative throat soreness compared to those treated with ketamine or saline. Over 92% of dexamethasone patients reported no throat pain within 2 hours after surgery.
Abstract
Postoperative Sore Throat (POST) may result in patient dissatisfaction and distress, which could possibly delay discharge. Various pharmacological and non-pharmacological approaches have been explored, yet effective techniques remain elusive. This research evaluates the impact of intra-cuff Dexamethasone, Ketamine, and normal saline on alleviating POST symptoms. In this randomized controlled trial, 405 adult patients aged 18‒60 years undergoing short pelvic laparoscopic surgeries under general anesthesia for 1‒3 hours requiring endotracheal intubation were enrolled. Patients were randomized into Group N (intra-cuff normal saline), Group D (intra-cuff Dexamethasone), and Group K (intra-cuff Ketamine). The primary outcome of this study was the incidence and severity of POST at 2-, 6-, 12-, and 24-hours after extubation. Secondary outcomes were the incidence and severity of postoperative hoarseness of voice and postoperative cough at various time intervals. There were more patients in Group D without symptoms of POST (92.59%) than in Group K (74.07%) and Group N (67.41%) (p < 0.0001) at 2 hours. Similarly, more patients had no symptoms of postoperative hoarseness of voice (93.33%) and postoperative cough (93.33%) in Group D at 2 hours. Furthermore, Group D consistently exhibited the lowest incidence of POST, postoperative hoarseness of voice, and postoperative cough at various time intervals. Intra-cuff Dexamethasone appears to be a favourable intervention for symptom alleviation of POST, postoperative hoarseness of voice, and postoperative cough during the early postoperative period. CTRI/2022/08/044664.