Effects of Nebulized Dexamethasone Versus Nebulized Ketamine on the Attenuation of Post-operative Sore Throat Following Endotracheal Intubation

ABSTRACT

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.