effect of local heat on incidence of sore throat and hoarseness after endotracheal intubation

Sore-throat and hoarseness are the most common complication after endotracheal intubation which take place 12-24 hr after operation. Different studies have reported the incidence of these complications between 24-90%. Increase of heat on the trachea will raise the blood pressure in the local capillaries and therefore induce better blood supplementation to the local tissues. This study aimed to evaluate the effect of local heat on the incidence of sore- throat and hoarseness after endotracheal intubations. One hundred and sixty patients aging 15 -50 years old, candidate for elective surgeries under general anesthesia, were randomly divided into two groups. Patients for head and neck surgeries were excluded from the study. Methods of intubation, type, size, cuff pressure of ETT, method of anesthesia and time of operation were the same for all patients. During the operation time, local heat was applied on the external surface of trachea [up to 40 [oc] by using electrical blanket for the patients in the study group. 24 hr after operation all the patients were visited by anesthesiologist for evaluating the sore- throat and hoarseness. The incidence of sore-throat in the control group was 65% versus 40% in the study group [p<0.05]. Moreover the incidence of hoarseness was 66.2% in the control group versus 10% in the case group. Application of local heat [40[oc] on the external surface of trachea can effectively decreases the incidence of postoperative sore - throat and hoarseness

[ effect of suppository diclofenac na on post operative shivering in elective caesarian section surgery]

Introduction and Objective: post-operative shivering is a common complication of general anesthesia with a reported incidence of 40-70 percent. It increases metabolic rate of oxygen demand, cardiac output, intracranial pressure, surgical incision retracture and post-operative pain. Various drugs such as NSAIDS have been used to treat or prevent post-anesthetic shivering. The aim of this study was to determine the effect of Diclofenac Na suppository on post-anesthetic shivering

Materials and Methods: this is a double? blind randomized clinical trial performed on 120 primiparous women undergone elective Caesarian delivery. They were randomly divided into two case and control groups. Vital signs of all the patients were measured before anesthesia and recorded. Drugs used for premedication, induction and maintenance of anesthesia were the same in both groups. Just before the induction of general anesthesia, patients in case group received one suppository [100 mg] of diclofenac Na. Shivering was evaluated during 60 minutes after extubation and vital signs were measured as well. The data were analyzed by SPSS software

Results: post anesthetic shivering was observed in 61/7% of control group and 5% of case group [p< 0. 0001]. Post anesthetic hypothernia was much more frequent in control group in comparison with Diclofenac Na group [p<0. 0001]. In comparison with control group, case group had more stability in body temperature

Conclusion: results of this study indicate that a single dose of suppository Diclofenac Na [100 mg] prevents post-anesthetic shivering without significant effect on body temperature. Accordingly, it can be suggested that suppository Diclofenac Na can be used for the management of post operative shivering