Background- Postoperative Sore Throat (POST) is an unpleasant complaint after endotracheal intubation. It can be prevented altogether with simple measures like either spray or nebulization with lignocaine.

Methods- In this prospective randomized study250 consenting patients (18-60 years, ASA I &II) were studied for POST after intubation. The two groups, group N and S received either preoperative nebulization with lignocaine 4% (1ml)in 4 ml of saline and 2 puffs of normal saline during intubation or nebulization with normal saline prior and lignocaine spray 10% (2 puffs) during intubation.

Results- Heart rate (HR) was consistently more in group N when observed at pre-nebulization (p=0.039), during nebulization (p= 0.022), on operation table (p=0.001), during induction (p<0.001), and at various intraoperative intervals. Mean Arterial Pressure (MAP) remained largely comparable in two groups (p=0.001). Oxygen saturation and sedation scores were similar across two groups.  Postoperatively, HR (p<0.01) and MAP (p<0.05) varied significantly during study duration. SpO2 and sedation levels were comparable (p<0.05). Group N reported less severity of sore throat (p<0.05) at 2, 4, 6 hours postoperatively and both groups showed similar resolution of sore throat at 12 and 24 hours. The Pearson Chi-Square test value of 1.641 and 0.672 (p=0.650 and 0.715), indicated no statistically significant difference in sore throat severity between males and females respectively in Groups N and S.

Conclusion- Group N had lower incidence and severity of sore throat in the early postoperative period, and symptoms resolved by 12-24 hours. Heart rate and MAP were higher and sedation and saturation was maintained throughout.

Keywords- Postoperative sore throat (POST), Nebulization, Lignocaine spray.

1. Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad. 2007 Apr-Jun;19(2):12-4.
2. Zuccherelli l. Post operative upper airway problems- review article. Saaja. 2003(9): 12-16
3. Mitobe Y, Yamaguchi Y, Baba y, Yoshioka T, Nakagawa K, Itou T, Kurahashi K.A Literature Review of Factors Related to Postoperative Sore Throat. Journal of Clinical Medicine Research.2022 Feb: 14(2):88.
4. Mchardy FE, chung F. Post-operative sore throat causes, prevention and treatment. Anesthesia 1999;54:   444-53.                             
5. Christensen AM, Willemoes-Larsen H, Lundby L, Jakobsen KB. Postoperative throat complaints after tracheal intubation. British Journal of Anaesthesia 1994; 73: 786–7.
6. El-Boghdadly K, Bailey CR, Wiles MD. Postoperative Sore throat: a systematic review. Anaesthesia.2016 Jun; 71(6):706-17.
7. Patel N, Dhuliya S, Shah D. Comparative evaluation of incidence of post operative sore throat after nebulization with ketamine and magnesium sulfate in patients undergoing general anaesthesia requiring endotracheal intubation. Indian J Clin Anaesth 2022;9(2):227-232
8. Al-Qahtani AS, Messahel FM. Quality improvement in anesthetic practice–incidence of sore throat after using small tracheal tube. Middle East J Anesthesiol. 2005;18(1):179–83.
9. Hayward G., Thompson MJ, Heneghan CJ, Perera R, Glasziou PP.Corticosteroids for pain relief in sorethroat: Systemic review and meta-analysis. BMJ.;339(7719):488-90
10. Kalil DM, Silvestro LS, Austin PN. Novel preoperative pharmacologic methods of preventing postoperative sore throat due to tracheal intubation. AANA J.2014:82(3)188-197.
11. Dhoori S, Chaudhary S, Ram B ,et al. A Randomised Trial of Nebulized Lignocaine , Lignocaine spray, or Their Combination for Topical Anaesthesia During Diagnostic Flexible Bronchoscopy. Chest.2020 ;157(1):198-204. 
12. Rajan S, Malayil GJ, Varghese R, Kumar L. Comparison of usefulness of ketamine and magnesium sulfate nebulizations for attenuating postoperative sore throat, hoarseness of voice, and cough. Anesth Essays Res. 2017;11(2):287–93.
13. Ramsay MA, Savage TM, Simpson BR, Goodwin R. Controlled sedation with alphaxone -alphadone.Br Med J 1974;2 :656-659.
14. Bajracharya, Ashis Bajracharya, Gautam  Thapa, Chitra  Bhandari, Sabin. (2024). Effect of Nebulized Lignocaine on Prevention of Postoperative Sore Throat following Laparoscopic Cholecystectomy. Nepal Medical College Journal. 26. 138-143.
15. Roy A, Sofiullah M, Bandyopadhyay D, Manuar MB, Ray UK, Hajra BK. Comparative Study on the Efficacy of Lignocaine Nebulisation Vs Topical Lignocaine Spray in Attenuation of Haemodynamic Surge in Patients Undergoing Surgery Under General Anaesthesia- A Single Blinded Randomized Controlled Study. J Med Sci Health 2024; 10(1):52-58
16. Lee JY, Sim WS, Kim ES, Lee SM, Kim DK, Na YR, et al. Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients. J Int Med Res 2017;45(2).
17. Vaghela AP, Shah RS, Shah DV. Comparative evaluation of incidence of post operative sore throat after nebulization with ketamine and lignocaine in patients undergoing general anaesthesia. National Journal of Medical Research. 2019 Dec 31;9(04): 168-70.
18. Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anesth. 2002 Feb;14(1):15-8

Dr Vaijayanti Nitin Gadre