Effectiveness of lubrication of endotracheal tube cuff with chamomile-extract for prevention of postoperative sore throat and hoarseness.

PURPOSE OF THE STUDY: To determine the efficacy of lubrication of the endotracheal tube cuff with Chamomile extract (Kamillosan M) before intubation on postoperative sore throat and hoarseness. MATERIAL AND METHOD: The authors randomly assigned 161 patients ASA (American Society of Anesthesiologists) physical status I, II elective surgical, orthopedic, gynecological or urological into 2 groups. The study group received 10 puffs of total 370 mg of Chamomile extract (Kamillosan M spray) lubricated at cuff of endotracheal tube while the control group did not receive any lubrication before intubation. Standard general anesthesia with tracheal intubation was given in both groups. Sore throat and hoarseness were recorded in post anesthetic care unit and at 24 h after operation. RESULTS: One hundred and sixty-one ASA physical status I, II elective surgical patients were recruited. Forty one out of 81 patients (50.6%) in the Chamomile group, scored no postoperative sore throat in the post-anesthesia care unit compared with 45 out of 80 patients (56.3%) in the control group p=0.386. Postoperative sore throat and hoarseness both in the postanesthesia care unit and at 24 h postoperation were not statistically different. There was no statistically significant relationship between sore throat or hoarseness and postoperative nausea or vomiting, ASA physical status, gender, history of smoking, grade of laryngoscopic view, number of intubation attempts, condition during intubation, use of oral airway and couching during extubation. CONCLUSION: Lubrication of endotracheal tube cuff with Chamomile extract spray before intubation can not prevent post operative sore throat and hoarseness.

Intrathecal fentanyl in spinal anesthesia for appendectomy.

OBJECTIVE: The authors assessed the effectiveness of the administration of fentanyl in spinal anesthesia for appendectomy. MATERIAL AND METHOD: Forty patients randomized double-blind, were recruited to receive either 4 ml of 0.5% hyperbaric bupivacaine + 20 mg of fentanyl (Group F) or 4 ml of 0.5% hyperbaric bupivacaine 0.5% + 0.4 ml normal saline (Group S). RESULTS: There were no significant differences in the highest analgesic level between the groups. The number of segments regressed at 60 min in Group F was statistically less than in Group S (0 vs. 2; P 0.002). Group F showed significantly lower median VNS pain scores than Group S (0 vs. 3; P 0.004). Time to first required postoperative analgesics in Group F was significantly higher than in Group S (13.6 vs. 6.3 h, P < 0.001). The incidence of shivering in Group F was significantly lower than Group S (35% vs. 70%; P 0.023). There were no significant differences in the incidence of nausea, vomiting, hypotension and urinary retention. No patient developed respiratory depression or PDPH. The patients' satisfaction of spinal anesthesia was 100% in Group F and 80% in Group S. CONCLUSION: Intrathecal 20 microg fentanyl significantly improved the quality of analgesia, it prolonged the duration of bupivacaine in spinal anesthesia and delayed the analgesics requirement in the early postoperative period. Shivering was less frequently found in the fentanyl group.