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ObjectiveTo study the potential quality marker （Q-marker） of Tinosporae Radix associated with efficacy of "relieving sore throat" based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS）， multivariate statistical analysis （MSA）， and network pharmacology. MethodUPLC-Q-TOF-MS was used to identify the main chemical components in 18 batches of Tinosporae Radix. On this basis， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were employed to screen out the main marker components that caused differences between groups. Moreover， network pharmacology technology was applied to predict the potential "sore throat-relieving" components， and the molecular docking between the common components resulting from MSA and network pharmacology and the core targets was carried out to verify the marker components. ResultA total of 17 compounds， including alkaloids， diterpenoid lactones， and sterols， were identified by UPLC-Q-TOF-MS. Five main differential components were found by MSA： Columbamine， jatrorrhizine， palmatine， menisperine， and columbin. Network pharmacology analysis yielded six compounds： tetrahydropalmatine， palmatine， menisperine， fibleucin， neoechinulin A， and columbin which were selected as potential "sore throat-relieving" components of Tinosporae Radix. They may relieve sore throat by acting on interleukin-6， epidermal growth factor receptor， prostaglandin G/H synthase 2， matrix metalloproteinase-9， proto-oncogene tyrosine-protein kinase Src and other targets， and regulating Hepatitis B， influenza A， human T-cell virus infection， human cytomegalovirus infection， coronavirus disease-2019， and other signaling pathways. The common active components in Tinosporae Radix resulting from MSA and network pharmacology analysis were palmatine， menisperine， and columbin， which had high binding affinity with six core targets and can be used as the Q-marker components of Tinosporae Radix in "relieving sore throat". ConclusionThis study predicts the "sore throat-relieving" Q-marker of Tinosporae Radix， which lays a basis for developing the quality standard of Tinosporae Radix based on the efficacy and improving the quality evaluation system of the medicinal.
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Objective:To investigate the clinical manifestations of Epstein-Barr virus infection in children and the efficacy of interferon combined with ganciclovir.Methods:A total of 252 children with Epstein-Barr virus infection who received treatment in Liaocheng Maternal and Child Health Hospital from June 2018 to February 2020 were included in this study. They were randomly assigned to undergo treatment either with ganciclovir alone (control group, n = 126) or interferon combined with ganciclovir (experimental group, n = 126). General condition, clinical manifestation, clinical outcomes, and clinical efficacy were compared between the two groups. Results:The 252 children with Epstein-Barr virus infection were divided into four groups according to different age brackets: infancy (3.97%), early childhood (53.57%), preschool (28.97%), school age (13.49%). Children at the early childhood and preschool ages accounted for high proportions. Their clinical manifestations included fever, pharyngeal congestion, cervical lymph node swelling, and pharyngeal pain. Children with hepatosplenomegaly accounted for the highest proportion (44.12%) among those at the school age, and children with binocular edema accounted for the highest proportion (10.37%) among those at the early childhood age. The time to defervesce, eyelid edema, and lymph node regression in the experimental group were (3.55 ± 1.58) hours, (3.82 ± 1.17) hours, and (9.55 ± 1.60) hours respectively, which were significantly shorter than those in the control group [(4.40 ± 1.80) hours, (5.33 ± 1.58) hours, (10.44 ± 1.66) hours, t = 3.64, 2.47, 2.67, P < 0.001, P = 0.024, 0.009]. The total response rate was significantly higher in the experimental group than in the control group [96.03% (107/126) vs. 84.92% (121/126), χ2 = 9.03, P = 0.003]. Conclusion:Epstein-Barr virus infection has different clinical manifestations in children at different ages. Interferon combined with ganciclovir is more effective on Epstein-Barr virus infection than ganciclovir alone.
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Objective @# investigate the correlation between the ossification of the styloid hyoid ligament and Bell’s facial paralysis and provide a reference for clinical diagnosis and treatment.@* Methods@# A case of ossification of the bilateral stylohyoid ligament with Bell's facial palsy caused by ossification of the bilateral stylohyoid ligament was diagnosed by clinical manifestations, differential diagnosis and imaging examination. The surgical plan was determined, and combined surgical resection of the ossified area of the styloid hyoid ligament and the greater horn of the hyoid was performed. Postoperative cefoxitin sodium anti-inflammatory treatment, methylprednisolone hormone treatment, acyclovir antiviral treatment, mecobalamin nutritional neurotherapy, and the relevant literature were analyzed. @* Results@# The patient experienced pain when swallowing before surgery, disappearance of right frontal ridges, incomplete eyelid closure, and ptosis of mouth corners. An MRI scan of the brain excluded intracranial space-occupying lesions and resulted in the diagnosis of Bell’s facial paralysis. High-resolution CT of the styloid process confirmed ossification of the styloid hyoid ligament. Styloid process shortening and partial hyoid resection were performed under general anesthesia. Half a month after discharge, the symptoms of sore throat and pain in swallowing disappeared, facial nerve function recovered well, right eyelid closure function recovered well, and right mouth droop improved. The facial nerve function basically returned to normal after 1 month of follow-up. A review of the relevant literature showed that ossification of the stylohyoid ligament to form pseudojoint dilation can locally stimulate the peripheral facial nerve and lead to facial paralysis symptoms. @*Conclusion@# Ossification of the styloid hyoid ligament is usually characterized by pharyngeal pain, which can be confirmed by imaging examination. Ossification of the styloid hyoid ligament with facial paralysis is rare in the clinic, so it is necessary to make a clear diagnosis and treat the symptoms.
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OBJECTIVE@#To explore the effectiveness and feasibility of dexamethasone combined with oxybuprocaine hydrochloride gel on the prevention of postoperative sore throat after nasal endoscopy.@*METHODS@#In the study, 60 patients with American Society of Anesthesiologist (ASA) physical statuses Ⅰ to Ⅱ, aged 18 to 72 years, scheduled for elective nasal endoscope surgery under general anesthesia requiring endotracheal intubation were randomly divided into dexamethasone combined with oxybuprocaine hydrochloride gel group (G group, n=30) and control group (C group, n=30). The patients in the G group received dexamethasone 0.1 mg/kg before induction and the oxybuprocaine gel was applied to the endotracheal catheter cuff and the front end within 15 cm. The patients in the C group received the same dose of saline and the saline was applied to the endotracheal catheter cuff and the front end within 15 cm. Then, all the patients in the two groups received the same induction and anesthesia maintainance. The operation time, anesthesia time, emergence time, extubation time and departure time were recorded. The intraoperative infusion volume, blood loss volume, propofol, remifentanil, rocuronium dosage were also recorded. The adverse reactions such as intraoperative hypotension, bradycardia and postoperative agitation were recorded. The postoperative sore throat score was recorded at the end of operation and 4 h, 8 h, 12 h, and 24 h after operation.@*RESULTS@#Compared with the C group, the emergence time [(8.4±3.9) min vs. (10.8±4.7) min], extubation time [(8.8±3.7) min vs. (11.9±4.8) min], and departure time [(20.0±5.3) min vs. (23.0±5.8) min] were significantly shorter, and the propofol dosage [(11.8±1.8) mg/kg vs. (15.9±4.6) mg/kg], remifentanil dosage [(10.9±4.7) μg/kg vs. (14.1±3.6) μg/kg] were significantly less in the G group, and there was no difference of rocuronium dosage in the two groups. Compared with the C group the incidence of intraoperative hypotension [10%(3/30) vs. 30%(9/30)], bradycardia [16.7%(5/30) vs. 20%(6/30)] and postoperative agitation [6.7%(2/30) vs. 23.3%(7/30)] were significantly lower in the C group. The postoperative sore throat score at the end of operation, 4 h, 8 h, 12 h and 24 h after operation in the G group were significantly lower than in the C group respectively [0 (0, 1) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (0.75, 1), 0 (0, 0) vs. 1 (0, 1)].@*CONCLUSION@#Dexamethasone combined with oxybuprocaine hydrochloride gel was effective and feasible on the prevention of postoperative sore throat after nasal endoscopy.
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Adolescent , Adult , Aged , Humans , Middle Aged , Young Adult , Bradycardia/drug therapy , Dexamethasone/therapeutic use , Endoscopy/adverse effects , Hypotension/drug therapy , Intubation, Intratracheal/adverse effects , Pain/drug therapy , Pharyngitis/prevention & control , Postoperative Complications/prevention & control , Procaine/analogs & derivatives , Propofol , Remifentanil , RocuroniumABSTRACT
@#Introduction: Since pharyngitis in adults is one of the most common infectious diseases seen in general practitioner consultations in Malaysia, data on pharyngitis among adults concerning to its prevalence, socio-demographic, risk factors and clinical manifestations is very much lacking. This study aims to determine the prevalence of pharyngitis among adults in Sepang, Selangor, Malaysia from 2016 to 2017 and its associated demographic and risk factors. Methods: We conducted a cross-sectional study on 215 adult patients with a sore throat as the main symptom and who did not receive any antibiotic treatment within two weeks at three Malaysian primary care clinics. The researchers assessed the participants’ clinical manifestations and collected throat swabs for culture to determine the presence of group A streptococcus (GAS). Data on demographic characteristics, clinical manifestation and throat swab culture results were analyzed using chi-square test and multivariate logistic regression. Results: Pharyngitis was diagnosed in 130/215 (65%) adults with a sore throat. Only six isolates (2.8%) were identified as GAS. The overall mean age ± S.D was 36.43 ± 15.7. The majority of the participants were in the age group of 18-28 years. There were 42.3% males and 57.7% females; most participants were Malay 62.8%, followed by 30.2% Indian, 5.1% Chinese, and 1.9% other ethnicities. The most common symptom among the participants was cough 196 (91.2%), followed by rhinorrhea 161 (74.8%), tonsillar swelling or exudates 68 (31.6%), inflamed or reddish of pharynx 62 (28.8%), swollen anterior cervical lymph nodes 50 (23.3%), and fever ≥37.5°C 28 (13.0%). Conclusion: Besides, there was no significant association between pharyngitis and the demographic variables; the current findings emphasized that inflamed or reddish pharynx, tonsillar swelling or exudates were among the factors associated with pharyngitis.
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Background: Tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may account for postoperative sore throat, hoarseness and cough. Dexamethasone is a very potent long acting glucocorticoid with analgesic, anti-inflammatory and antiemetic effects which helps to reduce post-operative sore throat.Methods: A prospective double blinded randomized study was conducted involving 80 patients, dividing them into 2 groups. Group D received dexamethasone 0.1 mg/kg and group S received an equivalent volume of normal saline (placebo) intravenously before induction. Intubation was performed by an experienced anesthesiologist. Anesthesia induction and maintenance dosage were standardized for all patients. The incidence and severity of sore throat, hoarseness and cough were recorded at 1, 6 and 24 hours postoperatively by using four-point scale.Results: The overall incidence of sore throat and hoarseness was significantly reduced in dexamethasone group compared to placebo (normal saline) group. Incidence and severity of sore throat and hoarseness were assessed at 1 hour, 6 hours and 24 hours interval and found out that they were reduced in dexamethasone group compared to placebo group which was statistically significant at all intervals. But incidence and severity of cough reduced significantly only in the first hour. It was comparable at 6 and 24 hours between the groups.Conclusions: Dexamethasone was effective in reducing the incidence and severity of sore throat and hoarseness at 1, 6 and 24 hours. Incidence of postoperative cough was reduced significantly at 1 hour in the dexamethasone group.
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Background: Spinal anesthesia is the preferred modality of anesthesia for lower segment cesarean section, but it is complicatedwith hypotension and bradycardia, which may be harmful to both parturient and baby. Bezold–Jarisch reflex plays an importantrole through 5HT3 receptors located in intracardiac vagal nerve endings in causing hypotension and bradycardia. In this study, weevaluated the effect of ondansetron, as a 5HT3 receptor antagonist, on the hemodynamic response following spinal anesthesiain parturients undergoing elective lower segment cesarean section.Methodology: Sixty parturients who were scheduled for lower segment elective cesarean section were randomly allocated intotwo groups. Before giving the spinal injection, Group O (n = 30) received intravenous ondansetron 4 mg and Group S (n = 30)received normal saline. Blood pressure, heart rate, and vasopressor requirements were assessed.Results: Total dose of vasopressor (mephentermine) used in Group “O” was 78 mg (mean±SD = 2.60 ± 4.36) and in Group “S,”it was 168 mg (mean ± SD = 5.6 ± 4.43 (P = 0.010). In Group O, the incidence of hypotension was 9 out of 30 patients whilein Group S, 21 out of 30 patients developed hypotension at any point of surgery (χ2=9.6 and P = 0.002).Conclusion: Ondansetron 4 mg, given intravenously 5 min before spinal anesthesia, causes reduction in hypotension andvasopressor use in parturients undergoing elective lower segment cesarean section.
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BACKGROUND: Postoperative sore throat (POST) is defined as pain or discomfort in the throat following general anesthesia. Throat packs are used by many surgical subspecialties for different benifits, however they may increase the incidence of POST. Many interventions can be used to decrease incidence of POST. Triamcinolone acetonide (TA) is a moderately potent topical corticosteroid preparation. In this study, we hypothesized that soaking the throat pack with TA may decrease POST. METHODS AND MATERIAL: This prospective interventional comparative study was performed on 54 patients planned for Functional Endoscopic Sinus Surgeries (FEES) surgery. After endotracheal intubation, a standard length of oro-pharyngeal pack was placed, then patients were randomly allocated into: Group I: Oro-pharyngeal packs were soaked with 15 mg Triamcinolone acetonide 0.1% and Group II: packs were soaked with the same volume of lubricating gel (K-Y gel®). The patients were postoperatively asked about: sore throat, dysphagia, hoarseness of voice and nausea and vomiting. RESULTS: Thirty minutes and 24 hours after extubation, Group I patients showed lower but statistically insignificant sore throat scores. Two to six hours after extubation, Group I showed a statistically significant reduction in sore throat scores. Six patients suffered dysphagia in group I compared with 8 patients in group II. Hoarseness of voice occurred in 1 patient in group I and 3 patients in group II. No patient complained of nausea or vomiting. cONCLUSIÓN: Soaking oropharyngeal pack with triamcinolone acetonide in orabase gel was able to decrease POST in FESS patients.
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Humans , Male , Female , Adult , Paranasal Sinuses/surgery , Triamcinolone Acetonide/administration & dosage , Endoscopy/methods , Pain, Postoperative/prevention & control , Prospective StudiesABSTRACT
@#Objective: To determine the effectiveness of levodropropizine in reducing the incidence of post-operative sore throat (POST) among ear, nose, throat, head and neck (ENT-HNS) patients undergoing general endotracheal anesthesia. Methods: Design: Double-Blind, Randomized, Placebo Controlled Trial Setting: Tertiary Government Training Hospital Participants: Sixty (60) ENT-HNS patients aged between 19 to 60 years old admitted to the Southern Philippines Medical Center from January to March 2019 for surgeries on benign thyroid tumors, benign submandibular gland tumors and tonsils requiring orotracheal intubation were randomized into control and treatment groups of 30 patients each. Results: There was a statistically significant difference (p=.0016) in the incidence of POST 6 hours after surgery between control (25/30; 83%) and treatment (16/30; 53.33%) groups. However, confounders such as length and type of surgery (more females and tonsillectomy cases in the control group) were not fully eliminated by randomization. Conclusion: Perioperative levodropropizine significantly decreases the incidence of moderate (as well as mild) postoperative sore throat. It was not shown to decrease the incidence of severe sore throat. A larger cohort (adjusted for other confounders) may better describe the benefit of this treatment.
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Background: General anesthesia (GA) with endotracheal intubation is a frequent cause of airway mucosal trauma whichresults in the post-operative sore throat (POST), with an incidence of 21–65%. Although minor and self-limiting complication,it produces significant discomfort and annoyance to the patient. This study was aimed to compare the efficacy of nebulizeddexamethasone versus ketamine in preventing POST.Materials and Methods: After approval from the institutional ethics committee and written informed consent, 100 patients ofthe American Society of Anesthesiologists physical status 1–2, aged between 20 and 60 years of either sex, undergoing GAwith endotracheal intubation were included in this prospective, randomized, and double-blind study. Patients were randomizedinto two groups of 50 each (n = 50); Group D: Patients received dexamethasone 8 mg (2 ml) with 3 ml of normal saline (totalvolume of 5 ml) for nebulization and Group K: Patients received ketamine (preservative free) 50 mg (1 ml) with 4 ml of normalsaline (total volume of 5 ml) for nebulization. After 15 min of nebulization, induction was done, POST assessment was done at0, 2, 4, 6, 12, and 24 h post-extubation. The severity of POST was graded on a 4-point scale (0–3).Results: The total incidence of POST was 19% in this study. Five patients (10%) in dexamethasone group and 14 patients(28%) in ketamine group experienced POST (Fisher’s exact test, P = 0.039). Reduction in the incidence and severity of POSTin the dexamethasone group when compared to ketamine group at 2, 4, 6, and 12 h postoperatively is statistically significant(P < 0.05*).Conclusion: Pre-operative single dose of nebulized dexamethasone 8 mg effectively attenuates POST in patients followingGA with endotracheal intubation compared to nebulized ketamine 50 mg without any detrimental effects.
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Background: Postoperative sore throat is a common and disturbing complication after endotracheal intubation, leading to patient discomfort and dissatisfaction. Objective: To find out the efficacy of ketamine gargles in reducing the incidence and severity of postoperative sore throat after endotracheal intubation. Methods: We studied the role of preoperative ketamine gargles for reducing postoperative sore throat. Patients undergoing elective abdominal and pelvic surgery under general anaesthesia with endotracheal tube were included in the study. They were randomly allocated in two groups, each group comprising of 30 patients. Group 1 received preservative free ketamine 50mg in 29 ml distilled water. Group 2 gargled with 30 ml distilled water. Patients were asked to gargle for 30 seconds, 5minutes before induction of anaesthesia. Postoperatively sore throat was assessed at 0, 4, 8 and 24 hours after extubation. The severity of sore throat was assessed from mild to severe. Results: Immediately after extubation, 90% patients in group 2 had sore throat compared to 66.7% in group 1. 24 hours after extubation, the incidence decreased to 50% in group 2 and 13.3% in group 1. Similar decrease incidence was noted at 4 and 8 hours post extubation in group 1. No patient in group 1 complained of change in voice or hoarseness of voice. Conclusion: We found that preoperative gargling with ketamine is a simple and cost effective way to reduce the incidence and severity of postoperative sore throat.
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Background: Context: Complains of pain in throat have been recorded in patients subjected to intubation of the trachea to such an extent as requiring analgesic interventions.In the modern multi-modal analgesia approach, non-opioid and NSAID group of drugs are in vogue to provide perioperative analgesia. Ketorolac and Paracetamol are two such drugs employed to treat surgical pain. Aim: To study and compare the effectivity of Ketorolac and Paracetamol in decreasing throat pain following endotracheal intubation. Settings and design: Prospective randomised parallel assigned single blind control study. Methods: Conducted on 120 consenting adult patients who required endotracheal intubation for surgery.They were divided into 3 groups of 40 patients each - C, K and P.Group K patients were premedicated with IV Inj.Ketorolac and Group P patients with IV Inj.Paracetamol 10minutes before induction of anaesthesia.Group C patients were the Control group.All patients were administered standard identical general anaesthetics .After recovery from anaesthesia, the incidences and severity of pain in throat was assessed and graded.The observations were tabulated and statistically analysed. Statistical analysis used: OpenEpi online software. Results: Both Ketorolac and Paracetamol decreased incidences and severity of throat pain. Ketorolac premedication provided better results than Paracetamol. Conclusion: Intravenous Ketorolac and Paracetamol both lessen sore throat caused by tracheal intubation.
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Postoperative sore throat (POST) is a minor complication after general anaesthesia. Many agents have been used as lubricant to reduce the incidence of POST with variable efficacy. Methods: We conducted a study to compare the incidence of POST with 0.05% betamethasone gel and 2% lignocaine jelly as a lubricant for LMA insertion in patients undergoing general anaesthesia. Sixty subjects were divided randomly into two groups. Patients in Group B (n = 30) had 2.5 ml of 0.05% of betamethasone gel while the Group L had 2.5 ml of 2% lignocaine jelly applied on the cuff of LMA. After standard induction and insertion of LMA cuff inflated to 60 cm of H2O and was maintained at the same throughout the surgery. Results: In PACU, patients were inquired about sore throat at immediate and 24 h post operative period. POST was not observed in any of the patients of Group B. In group L 13% of the patients had 1st degree and 3% had 2nd degree of sore-throat in immediate post-operative period. After 24 h 3%patients had 1st degree sore-throat and 1% patients had 2nd degree of sore-throat in Group L patients. Conclusion: We conclude that lubricating cuff of LMA with 0.05% of betamethasone gel is effective in reducing the incidence of POST.
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Background : Supraglottic airway devices are quicker airway control devices even in inexperienced personel. It has better hemodynamic control, less complications and better avoids the disadvantages of the ET insertion. In our study, We compare the performance of CLASSIC LMA and AMBU LMA in minor gynecological procedures. Materials & Methods : In a Prospective randomised case control study, 30 patients in each group were enrolled. size 3 or 4 LMA was used in all adult patients under General anaesthesia without muscle relaxant. Results : AMBU LMA has 90% ease of insertion, 93.3% in first attempt, less time taken for insertion (15 seconds), better hemodynamic control in 5 minutes compared to CLASSIC LMA ( 63%,83.3%,24seconds respectively). Complications like sore throat, blood stain in throat is comparable in both LMA. Conclusion : AMBU LMA has superior performance compared to CLASSIC LMA, and has no significance in view of complications like sore throat.
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Background: Postoperative sore throat is the most common and most distressing complaint of patients after general anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff dexamethasone in reducing the incidence of this distressing postoperative symptom.Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal saline respectively. The cuff was prefilled with dexamethasone or normal saline one hour prior to intubation to allow time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs after surgery.Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients (8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of hoarseness of voice between the two groups.Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence of hoarseness of voice.
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Background: Postoperative sore throat (POST) is a slightcomplication after general anaesthesia. Numerous agents havebeen used as lubricant to lessen the incidence of POST withvariable efficacy.Methods: We compare the incidence of POST with 0.05%betamethasone gel and 2% lignocaine jelly as a lubricant forLMA insertion in patients undergoing general anaesthesia.Sixty subjects were separated randomly into two groups.Patients in Group B (n = 30) had 2.5 ml of 0.05% ofbetamethasone gel while the Group L had 2.5 ml of 2%lignocaine jelly applied on the cuff of LMA. After criterioninduction and insertion of LMA cuff inflated to 60 cm of H2Oand was maintained at the same throughout the surgery.Results: In PACU, patients evaluated about sore throat atimmediate and 24 h post-operative period. POST was not seenin any of the patients of Group B. In group L 13% of thepatients had 1st degree and 3% had 2nd degree of sore-throatin immediate post-operative period. After 24 h 3%patients had1st degree sore-throat and 1% patients had 2nd degree ofsore-throat in Group L patients.Conclusion: We conclude that lubricating cuff of LMA with0.05% of betamethasone gel is efficient in reducing theincidence of POST.
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Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p<0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.
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Resumen: Introducción: El dolor faríngeo postoperatorio es una complicación frecuente posterior a la intubación endotraqueal, caracterizado por odinofagia. Objetivo: Comparar ketamina nebulizada preoperatoria contra placebo para la disminución del dolor faríngeo postoperatorio en cirugía electiva bajo anestesia general. Material y métodos: Estudio experimental prospectivo, aleatorizado, doble ciego, realizado de febrero a julio del 2016. Dos grupos de pacientes aleatorizados: grupo K: ketamina nebulizada (50 mg: 1 mL de ketamina + 2 mL de solución salina 0.9%); grupo P: placebo (nebulización de 3 mL solución salina 0.9%). Se evaluaron signos vitales así como síntomas e intensidad del dolor faríngeo postoperatorio de acuerdo con la escala numérica análoga a la hora 1 y a la hora 4. Resultados: El uso de ketamina nebulizada no representa una ventaja estadísticamente significativa con relación al placebo para el dolor faríngeo postoperatorio. La incidencia de éste en nuestro estudio fue de 59.29%. Conclusiones: Se necesitan más estudios con ketamina nebulizada en vía aérea difícil en la población mexicana, así como una mayor muestra para poder determinar el estándar de oro para el tratamiento del dolor faríngeo postoperatorio.
Abstract: Introduction: The postoperative sore throat is a frequent complication, characterized by odynophagia after endotracheal intubation. Objective: To compare nebulized ketamine in the preoperative period against nebulized placebo for the reduction of the postoperative sore throat on elective surgery under general anesthesia. Material and methods: We performed an experimental, prospective, randomized, double blind study; conducted from February to July 2016. Patients were randomly assigned into two groups: group K: preoperative nebulized ketamine (50 mg: 1 mL of ketamine + 2 mL of saline solution 0.9%) against group P: placebo (nebulization of 3 mL saline solution 0.9%). We collected vital signs as well as symptoms and intensity of postoperative sore throat according to the analog numeric scale at the first and forth postoperative hours. Results: The use of nebulized ketamine does not represent a statistically significant difference compared to placebo for postoperative sore throat. The incidence of postoperative sore throat in our study was of 59.29%. Conclusions: We need further studies of nebulized ketamine in the Mexican population, as well as a larger study to determine the gold standard for the treatment of POST.
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PURPOSE: To investigate the differences in postoperative sore throat and hoarseness by adjustment of endotracheal tube cuff pressure (CP) during nitrous oxide (N2O) and air anesthesia. METHODS: A one-equivalent control group pretest-posttest design was used. Data were collected from August 8 to October 19, 2017 and analyzed using the independent t-test and repeated measures ANOVA. Eighty-four participants were enrolled and divided into three groups: 28 in the Control Group (CP adjusted every 30 minutes using N2O), 28 in Experimental Group 1 (CP adjusted every 10 minutes using N2O), and 28 in Experimental Group 2 (non-adjusted CP using air), all of whom underwent urologic, gynecologic, and orthopedic surgeries at the G University hospital. Sore throat was assessed using a numeric rating scale; hoarseness was evaluate using the Stout classification at 1, 6, and 24 hours after surgery. RESULTS: Scores for sore throat and hoarseness were significantly different between the groups at each measurement time, and scores were consistently higher in the control group. During subsequent measurements, sore throat and hoarseness scores were significantly lower at 6 hours. Cuff pressure changed significantly using air anesthesia (χ2=10.41, p=.015) up to 2 hours after induction. Severe sore throat and hoarseness was observed for up to 6 hours after surgery. CONCLUSION: Cuff pressure adjustment at short time intervals would be helpful in reducing postoperative sore throat and hoarseness. Nursing intervention focused on prevention of sore throat and hoarseness should be required up to 6 hours postoperatively in patients undergoing endotracheal intubation.
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Humans , Anesthesia , Classification , Hoarseness , Intubation , Intubation, Intratracheal , Nitric Oxide , Nitrous Oxide , Nursing , Orthopedics , PharyngitisABSTRACT
@#Background: Endotracheal tube cuff (ETTc) inflation pressure is usually not regarded as an important aspect during intubation. In this study, we compared measuring ETTc pressure and pilot balloon palpation method in causing post-operative airway complications. Methods: Two hundred and ninety-two surgical patients requiring intubation were recruited into this prospective, double-blind, randomised controlled study. Group A patients had their ETTc initially inflated, checked by a cuff pressure gauge, recorded and then set to 25 cmH2O. Group B patients had their ETTc inflated using the pilot balloon palpation method. Patients were then followed up for post-operative sore throat, hoarseness and cough. Results: The overall incidence of post-operative sore throat was 39.0% versus 75.3% (P < 0.001), hoarseness 6.2% versus 15.1% (P < 0.05) and cough 7.5% versus 21.9% (P < 0.05) in Group A and B, respectively. Group A patients experienced a significant reduction in the incidence and severity of sore throat up to 24 h post-operatively (P < 0.001), hoarseness at the first hour (P = 0.004) and cough at first and 12 h post-operatively (P = 0.002). Conclusion: Adjusting the ETTc pressure to 25 cmH2O reduces post-operative sore throat, hoarseness and cough compared to pilot balloon palpation method.