Postoperative sore throat
Authors:
Dostálová Kateřina 1; Doubravská Lenka 1; Fritscherová Šárka 1; Pospíšilová Dagmar 2; Zapletalová Jana 3; Adamus Milan 1
Authors‘ workplace:
Klinika anesteziologie a resuscitace FN a LF UP v Olomouci, 2Otolaryngologická klinika FN a LF UP v Olomouci, 3Ústav lékařské biofyziky, LF UP Olomouc
1
Published in:
Anest. intenziv. Med., 21, 2010, č. 4, s. 172-178
Category:
Anaesthesiology - Original Paper
Overview
Objective:
To assess the incidence and risk factors for postoperative sore throat.
Design:
A prospective, observational, double-blind study.
Setting:
Departments and ICUs of Surgery, Trauma, Plastic and Aesthetic Surgery, Urology and Gynaecology, University Hospital Olomouc.
Materials and methods:
The study comprised of 1,942 patients after elective surgery who were inquired about sore throat and other peri-operative complaints on the 1st postoperative day. If sore throat or hoarseness were present on the 1st postoperative day, the patients were re-examined on the 3rd postoperative day. Patients with sore throat persisting till the 3rd postoperative day were referred for an ENT examination. Patient records from the recovery room and wards as well as the anaesthetic records were used to find out about the demographic data and anaesthetic management. The data were processed using appropriate statistical tests.
Results:
A total of 16.2% of patients had postoperative sore throat on the day of surgery, occurring at various rates depending on the type of airway management during general anaesthesia. Sore throat was the most frequent after endotracheal intubation (18.3 %) and laryngeal mask insertion (12.8 %). The lowest rates of sore throat were reported after face mask ventilation (4 %). The way the tracheal tube tip was prepared prior to tracheal intubation had a prominent influence as well. Both local anaesthetic (Mesocain) jelly and water increased the incidence of sore throat two-fold as compared with K-Y jelly or no pre-treatment. Gender (p = 0.712), BMI (p = 0.982), anaesthesiologist’s experience (p = 0.311), nasogastric tube insertion (p = 0.522) or smoking (p = 0.691) did not influence the incidence of sore throat.
Conclusion:
The technique of peri-operative airway management and lubricant use during general anaesthesia significantly affect the incidence of postoperative sore throat.
Keywords:
postoperative complications – sore throat – face mask – intubation – laryngeal mask – lubrication
Sources
1. Dostálová, K. et al. Pooperační bolesti v krku (SS – Sore Throat). In Sborník abstrakt 16. kongresu ČSARIM, České Budějovice. 1.–3. října 2009. Abstrakta volných sdělení – lékařská sekce. Praha: Občanské sdružení ČSARIM 2007–2010, CD-ROM. p. 10. ISBN 978-80-254-5367-4.
2. Reber, A., Hauenstein, L., Echternach, M. Pharyngolaryngeale Beschwerden nach Allgemeinanästhesien. Anaesthesist, 2007, 56, p. 177–189.
3. Myles, P. S. et al. Patient satisfaction after anaesthesia and surgery: Results of a prospective survey of 10 811 patients. Br. J. Anaesth., 2000, 84, p. 1–2.
4. Biro, P., Seifert, B., Pasch, T. Complaints of sore throat after tracheal intubation: A prospective evaluation. Eur. J. Anaesthesiol., 2005, 22, p. 307–311.
5. McHardy, F. E., Chung, F. Postoperative sore throat: Cause, prevention and treatment, Anaesthesia, 1999, 54, p. 444–453.
6. Domino, K. B. et al. Airway Injury during Anesthesia: a closed claims analysis. Anesthesiology, 1999, 91, p. 1703–1711.
7. Monroe, M. C. et al. Effect of Oropharyngeal Airway in Orotracheally Intubated Patients. Anesth. Analg., 1990, 70, p. 512–516.
8. Owens, W. D., Felts, J. A., Spitznagel, E. L. ASA Physical Status Classifications: A Study of Consistency of Ratings. Anesthesiology, 1978, 49, p. 239–243.
9. Čihák, R. Anatomie 3. 1. vyd. Praha: Grada Publishing, 1997, p. 416–420. ISBN 80-7169-140-2.
10. Kori, K. et al. The influence of endotracheal tube cuff lubrication on postoperative sore throat and hoarseness. Masui, 2009, 58, p. 342–345.
11. Sumathi, P. A. et al. 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., 2007, 100, p. 215–218.
12. Navarro, L. H. C. et al. Effectiveness and safety of endotracheal tube cuffs filled with air versus filled with alkalinized lidocaine: A randomized clinical trial. Sao Paulo Med. J., 2007, 125, p. 322–328.
13. Estebe, J. et al. Alkalinization of Intracuff Lidocaine: Efficacy and Safety. Anesth. Analg., 2005, 101, p. 1536–1541.
14. Kati, I. et al. Does Benzydamine Hydrochloride Applied Preemptively Reduce Sore Throat Due to Laryngeal Mask Airway? Anesth. Analg., 2004, 99, p. 710–712.
15. Higgins, P. P., Chung, G., Mezei, G. Postoperative sore throat after ambulatory surgery. Br. J. Anaesth., 2002, 88, p. 582–584.
16. Rieger, A. et al. Laryngo-pharyngeal complaints following laryngeal mask airway and endotracheal intubation. Anesthesiology, 2000, 93, p. 26–31.
17. Hamdan, A. L. et al. Immediate post-operative vocal changes in patients using laryngeal mask airway versus endotracheal tube. J. Laryngol. Otol., 2008, 122, p. 829–835.
18. Suzuki, N. et al. Postoperative hoarseness and sore throat after tracheal intubation: Effect of a low intracuff pressure of endotracheal tube and the usefulness of cuff pressure indicator. Masui, 1999, 48, p. 1091–1095.
19. Karasawa, F. et al. The Effect on Intracuffe Pressure of Various Nitrous Oxide Concentrations Used for Inflating an Endotracheal Tube Cuff. Anesth. Analg., 2009, 91, p. 708–713.
20. Brimacombe, J. et al. Pharyngolaryngeal, Neck, and Jaw Discomfort after Anesthesia with the Face Mask and Laryngeal Mask Airway at High and Low Cuff Volumes in Males and Females. Anesthesiology, 2000, 93, p. 26–31.
21. Rieger, A. et al. Intubation trauma of the larynx- a literature review with special reference to arytenoid cartilage dislocation. Anaestesiol Intensivmed Notfallmed Schmerzther, 1996, 31, p. 281–287.
22. Ogata, J. et al. Gargling with Sodium Azulene Sulfonate Reduces the Postoperative Sore Throat After Intubation of the Trachea. Anesth. Analg., 2005, 101, p. 290–293.
23. Agarwal, A. et al. An Evaluation of the Efficacy of Aspirin and Benzydamine Hydrochloride Gargle for Attenuating Postoperative Sore Throat: A Prospective, Randomized, Single-Blind Study. Anesth. Analg., 2006, 103, p. 1001–1003.
Labels
Anaesthesiology, Resuscitation and Inten Surgery Intensive Care Medicine Neurology Orthopaedics Nurse Traumatology Trauma surgeryArticle was published in
Anaesthesiology and Intensive Care Medicine
2010 Issue 4
Most read in this issue
- Postoperative sore throat
- Prometheus therapy in patients with acute liver failure – the effect on the inflammation and regeneration markers
- Prometheus – a new therapeutic option in liver failure in children
- Brachial plexus fascias