Background and Objectives: Controlled comparison between 0.05% betamethasone gel, 2% lidocaine jelly, lubricating gel applied over endotracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice at 0,6,&24 hrs

Patients and Methods: This study compares the incidence of postoperative sore throat, cough, and hoarseness of voice after general anaesthesia when applying betamethasone gel (betamethasone group-B) or lidocaine jelly (lidocaine group -L) on the tracheal tube. 120 ASA class I and II patients undergoing elective surgeries under general anaesthesia with orotracheal intubation were randomized into three groups: betamethasone gel, lidocaine jelly, and control groups (C group). In the post-anaesthesia care unit, all patients were interviewed on postoperative sore throat, cough, and hoarseness of voice at 0, 6, and 24 h after surgery.

Results and Conclusion: A wide spread application of betamethasone gel (B) on the endotracheal tube decreases the incidence and severity of postoperative sore throat, cough, and hoarseness of voice as compared to lignocaine group(L) and control group (c).

Keywords:  betamethasone , lignocaine , sorethroat, hoarsness of voice, cough.

1. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582–4. doi:10.1093/bja/88.4.582. (http://bja.oxfordjournals.org/content/88/4/582.long). Accessed 28 Apr 2014. [PubMed]
2. Biro P, Seifert B, Pasch T. Complaints of sore throat after tracheal intubation: a prospective evaluation. Eur J Anaesthesiol. 2005;22(4):307–11. doi:10.1017/S0265021505000529. (http://www.ncbi.nlm.nih.gov/pubmed/15892411). Accessed 25 Jan 2012. [PubMed]
3. Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad. 2007;19(2):12–4. (http://ayubmed.edu.pk/JAMC/PAST/19-2/03%2006-101%20Alyia%20Ahmed.pdf). Accessed 25 Jan 2012. [PubMed]
4. Selvaraj T, Dhanpal R. Evaluation of the application of topical steroids on the endotracheal tube in decreasing postoperative sore throat. J Anaesthesiol Clin Pharmacol. 2002;18:167–170.  [Google Scholar]
5. 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(2):215–8. doi:10.1093/bja/aem341. (http://bja.oxfordjournals.org/content/100/2/215.full.pdf). Accessed 26 Jan 2012. [PubMed]
6. Yamanaka H, Hayashi Y, Watanabe Y, Uematu H, Mashimo T. Prolonged hoarseness and arytenoid cartilage dislocation after tracheal intubation. Br J Anaesth. 2009;103(3):452–5. doi:10.1093/bja/aep169. (http://bja.oxfordjournals.org/content/103/3/452.long). Accessed 15 Oct 2011. [Pubmed}.
7. Agarwal A, Gupta D, Yadav G, Goyal P, Singh PK, Singh U. An evaluation of the efficacy of licorice gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study. Anesth Analg. 2009;109:77–81. doi:10.1213/ane.0b013e3181a6ad47. Accessed 24 Oct 2016. [PubMed]
8. Ayoub CM, Ghobashy A, Koch ME, McGrimley L, Pascale V, Qadir S, et al. Widespread application of topical steroids to decrease sore throat, hoarseness, and cough after tracheal intubation. Anesth Analg. 1998;87(3):714–6. doi:10.1213/00000539-199809000-00042. Accessed 26 Jan 2012. [PubMed]
9. Fuller PB. The relationship between preintubation lidocaine and postanesthesia sore throat. AANA J. 1992;60(4):374–8. Accessed 22 Oct 2016. [PubMed]
10. Takekawa K, Yoshimi S, Kinoshita Y. Effects of intravenous lidocaine prior to intubation on postoperative airway symptoms. J Anesth. 2006;20(1):44–47. doi: 10.1007/s00540-005-0363-8. [PubMed] [CrossRef] [Google Scholar]
11. Klemola UM, Saarnivaara L, Yrjola H. Post-operative sore throat: effect of lignocaine jelly and spray with endotracheal intubation. Eur J Anaesthesiol. 1988;5(6):391–9. (http://www.ncbi.nlm.nih.gov/pubmed/3240760). Accessed 24 Oct 2016. [PubMed]
12. Kori K, Muratani T, Tatsumi S, Minami T. Influence of endotracheal tube cuff lubrication on postoperative sore throat and hoarseness. Masui. 2009;58(3):342–5. (http://www.ncbi.nlm.nih.gov/pubmed/19306635). [PubMed]
13. Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anesth. 2002;14(1):15–8. doi:10.1016/S0952-8180(01)00344-0. (http://www.sciencedirect.com/science/article/pii/S0952818001003440?np=y). [PubMed]
14. Rudra A, Ray S, Chatterjee S, Ahmed A, Ghosh S. Gargling with ketamine attenuates the postoperative sore throat. Indian J Anaesth. 2009;53(1):40–3. (http://www.ijaweb.org/text.asp?2009/53/1/40/60255). Accessed 31 Dec 2011. [PMC free article] [PubMed]
15. Shrestha SK, Bhattarai B, Singh J. Ketamine gargling and postoperative sore throat. J Nepal Med Assoc. 2010; 50(180):282–5. (http://jnma.com.np/journal/index.php/jnma/article/view/55). Accessed 12 Jan 2012. [PubMed]
16. Kazemi A, Amini A. The effect of betamethasone gel in reducing sore throat, cough, and hoarseness after laryngo-tracheal intubation. Middle East J Anesthesiol. 2007;19(1):197–204. (http://www.meja.aub.edu.lb/downloads/19_1/197.pdf). Accessed 30 Nov 2011. [PubMed]
17. 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(4):541–3. doi:10.1093/bja/aeh098. (http://bja.oxfordjournals.org/content/92/4/541.full). [PubMed].

Dr M. Raja

Assistant Professor, Institute of Anaesthesiology, Madurai Medical College, Madurai, Tamil Nadu, India