Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2013.07.001
Brazilian Journal of Anesthesiology
Scientific Article

Reducing sore throat following laryngeal mask airway insertion: comparing lidocaine gel, saline, and washing mouth with the control group

Redução da dor de garganta após a inserção de máscara laríngea: comparação de gel de lidocaína, salina e lavagem da boca com o grupo controle

Mehryar Taghavi Gilani; Iman Miri Soleimani; Majid Razavi; Maryam Salehi

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Abstract

BACKGROUND: Laryngeal mask airway is still accompanied by complications such as sore throat. In this study, effects of three methods of reducing postoperative sore throat were compared with the control group. METHODS: 240 patients with ASA I, II candidates for cataract surgery were randomly divided into four same groups. No supplementary method was used in the control group. In the second, third and fourth groups, lidocaine gel, washing cuff before insertion, and washing mouth before removing laryngeal mask airway were applied, respectively. Anesthesia induction was done with fentanyl, atracurium, and propofol and maintained with propofol infusion. The incidence of sore throat was evaluated during the recovery, 3-4 h later and after 24 h using verbal analog scale. The data were analyzed by t-test, analysis of variance and chi-square using SPSS V11.5. RESULTS: Age, gender, duration of surgery and cuff pressure were the same in all the four groups. Incidence of sore throat at recovery room was highest in the control group (43.3%) and lowest in the washing mouth group (25%). However, no significant statistical difference was observed between these four groups (recovery, p = 0.30; discharge, p = 0.31; examination, p = 0.52). In this study, increased duration of operation had a significant relationship with the incidence of sore throat (p = 0.041). CONCLUSION: Sore throat is a common postoperative problem, but no special method has been found completely efficient yet. In this study, cuff washing, lidocaine gel, and mouth washing before removing laryngeal mask airway were not helpful for sore throat.

Keywords

Sore throat, Laryngeal mask airway, Lidocaine, Washing mouth, Saline

Resumo

JUSTIFICATIVA: A máscara laríngea ainda é relacionada a complicações como a dor de garganta. Neste estudo, os efeitos de três métodos para reduzir a dor de garganta, no período pós-operatório, foram comparados com o grupo controle. MÉTODOS: Duzentos e quarenta candidatos,com estado físico ASA I-II, foram aleatoriamente divididos em quatro grupos iguais para a cirurgia de catarata.com estado físico ASA I-II, candidatos para a cirurgia de catarata foram aleatoriamente divididos em quatro grupos iguais. Nenhum método complementar foi usado no grupo controle. No segundo, terceiro e quarto grupos, os métodos utilizados foram: Aplicação de gel de lidocaína, lavagem do manguito antes da inserção e lavagem da boca antes de remover a máscara laríngea, respectivamente. A anestesia foi induzida com fentanil, atracúrio e propofol e mantida com propofol. A incidência de dor de garganta foi avaliada durante a recuperação, 3-4 h depois e após 24 h usando uma escala verbal analógica. Teste-t, análise de variância e teste do qui-quadrado foram usados para a análise dos dados por meio do programa estatístico SPSS V11.5. RESULTADOS: Idade, gênero, tempo de cirurgia e pressão do manguito foram semelhantes em todos os quatro grupos. Na sala de recuperação, a incidência de dor de garganta foi maior no grupo controle (43,3%) e mais baixa no grupo lavagem da boca (25%). No entanto, não houve diferença estatisticamente significante entre os quatro grupos (recuperação, p = 0,30; alta, p = 0,31; exame, p = 0,52). Neste estudo, o tempo mais longo de cirurgia apresentou relação significativa com a incidência de dor de garganta (p = 0,041). CONCLUSÃO: Dor de garganta é um problema pós-operatório comum, mas nenhum método em especial foi considerado totalmente eficiente. Neste estudo, a lavagem do manguito, a aplicação de gel de lidocaína e a lavagem de boca antes de remover a máscara laríngea não foram úteis para evitar a dor de garganta.

Palavras-chave

Dor de garganta, Máscara laríngea, Lidocaina, Lavagem da boca, Salina

References

Wakeling HG, Butler PJ, Baxter PJ. The laryngeal mask airway: a comparison between two insertion techniques. Anesth Analg.. 1997;85:687-90.

McHardy FE, Chung F. Postoperative sore throat: cause, preven- tion and treatment. Anaesthesia.. 1999;54:444-53.

Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth.. 2002;88:582-4.

Joshi GP, Inagaki Y, White PF. Use of the laryngeal mask airway as an alternative to the tracheal tube during ambulatory anesthesia. Anesth Analg.. 1997;85:573-7.

Dingley J, Whitehead MJ, Wareham K. A comparative study of the incidence of sore throat with the laryngeal mask airway. Anaesthesia.. 1994;49:251-4.

Krishna HM, Kamath S, Shenoy L. Insertion of LMA ClassicTMwith and without digital intraoral manipulation in anes- thetized unparalyzed patients. J Anaesthesiol Clin Pharmacol.. 2012;28:481-5.

Choo CY, Koay CK, Yoong CS. A randomised controlled trial com- paring two insertion techniques for the Laryngeal Mask Airway FlexibleTMin patients undergoing dental surgery. Anaesthesia.. 2012;67:986-90.

Koay CK, Yoong CS, Kok P. A randomized trial comparing two laryngeal mask airway insertion techniques. Anaesth Intensive Care.. 2001;29:613-5.

Hung NK, Wu CT, Chan SM. Effect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. Anesth Analg.. 2010;111:882-6.

Kati I, Tekin M, Silay E. Does benzydamine hydrochloride applied preemptively reduce sore throat due to laryngeal mask airway?. Anesth Analg.. 2004;99:710-2.

Sumathi PA, Shenoy T, Ambareesha M. Controlled com- parison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Anaesth.. 2008;100:215-8.

Rieger A, Brunne B, Striebel HW. Intracuff pressures do not pre- dict laryngopharyngeal discomfort after use of the laryngeal mask airway. Anesthesiology.. 1997;87:63-7.

Brimacombe J, Holyoake L, Keller C. Pharyngolaryngeal, neck, and jaw discomfort after anesthesia with the face mask and laryngeal mask airway at high and low cuff volumes in males and females. Anesthesiology.. 2000;93:26-31.

Keller C, Sparr HJ, Brimacombe JR. Laryngeal mask airway lubri- cation. A comparative study of saline versus 2% lignocaine gel with cuff pressure control. Anaesthesia.. 1997;52:592-7.

Figueredo E, Vivar-Diago M, Munoz˜-Blanco F. Laryngo- pharyngeal complaints after use of the laryngeal mask airway. Can J Anaesth.. 1999;46:220-5.

Chia YY, Lee SW, Liu K. Propofol causes less postoperative pha- ryngeal morbidity than thiopental after the use of a laryngeal mask airway. Anesth Analg.. 2008;106:123-6.

Keller C, Brimacombe J. Spontaneous versus controlled respi- ration with the laryngeal mask airway. A review. Anaesthesist.. 2001;50:187-91.

Hemmerling TM, Beaulieu P, Jacobi KE. Neuromuscular blockade does not change the incidence or severity of pharyn- golaryngeal discomfort after LMA anesthesia. Can J Anaesth.. 2004;51:728-32.

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