Comparison of the effect of intra-cuff normal saline,
dexamethasone or ketamine for prevention of
postoperative sore throat: a randomized controlled trial

Arun Mukesh; Ankur Sharma; Priyabrat Karan; Darshna Rathod; Shilpa Goyal; Kamlesh Kumari; Manbir Kaur; Tanvi Meshram; Pradeep Bhatia

doi:10.1016/j.bjane.2025.844651

Original Investigation

Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: a randomized controlled trial

Comparação do efeito de solução salina normal intracuff, dexametasona ou cetamina na prevenção de dor de garganta pós-operatória: um ensaio clínico randomizado

Arun Mukesh, Ankur Sharma, Priyabrat Karan, Darshna Rathod, Shilpa Goyal, Kamlesh Kumari, Manbir Kaur, Tanvi Meshram, Pradeep Bhatia

http://dx.doi.org/10.1016/j.bjane.2025.844651 Braz J Anesthesiol, vol.75, n5, 844651, 2025

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Abstract

Background

Postoperative Sore Throat (POST) may result in patient dissatisfaction and distress, which could possibly delay discharge. Various pharmacological and non-pharmacological
approaches have been explored, yet effective techniques remain elusive. This research evaluates the impact of intra-cuff Dexamethasone, Ketamine, and normal saline on alleviating POST symptoms.

Methods

In this randomized controlled trial, 405 adult patients aged 18‒60 years undergoing short pelvic laparoscopic surgeries under general anesthesia for 1‒3 h requiring endotracheal
intubation were enrolled. Patients were randomized into Group N (intra-cuff normal saline), Group D (intra-cuff Dexamethasone), and Group K (intra-cuff Ketamine). The primary outcome of this study was the incidence and severity of POST at 2, 6, 12, and 24 hours after extubation. Secondary outcomes were the incidence and severity of postoperative hoarseness of voice and postoperative cough at various time intervals.

Results

There were more patients in Group D without symptoms of POST (92.59 %) than in Group K (74.07 %) and Group N (67.41 %) (p < 0.0001) at 2 h. Similarly, more patients had no symptoms of postoperative hoarseness of voice (93.33 %) and postoperative cough (93.33 %) in Group D at 2 h. Furthermore, Group D consistently exhibited the lowest incidence of POST, postoperative hoarseness of voice, and postoperative cough at various time intervals.

Conclusion

Intra-cuff Dexamethasone appears to be a favourable intervention for symptom alleviation of POST, postoperative hoarseness of voice, and postoperative cough during the early
postoperative period.

Clinical Trial Registry Number: CTRI/2022/08/044,664.

Supplementary materials: Supplementary material associated with this article can be found in the online version at doi: 10.1016/j.bjane.2025.844651.

Keywords

Cough; Dexamethasone; Hoarseness; Ketamine; Pain; Postoperative

Resumo

Introdução

A dor de garganta pós-operatória (POST) pode resultar em insatisfação e desconforto do paciente, possivelmente retardando a alta hospitalar. Diversas abordagens farmacológicas e não farmacológicas foram estudadas, porém técnicas eficazes ainda são escassas. Esta pesquisa avalia o impacto da dexametasona, cetamina e solução salina normal intracuff na redução dos sintomas de POST.

Métodos

Neste ensaio clínico randomizado controlado, 405 pacientes adultos com idade entre 18 e 60 anos, submetidos a cirurgias laparoscópicas pélvicas de curta duração (1 a 3 horas) sob anestesia geral e intubação traqueal, foram incluídos. Os pacientes foram randomizados em três grupos: Grupo N (solução salina normal intracuff), Grupo D (dexametasona intracuff) e Grupo K (cetamina intracuff). O desfecho primário foi a incidência e gravidade da POST nas 2, 6, 12 e 24 horas após a extubação. Os desfechos secundários foram a incidência e gravidade de rouquidão pós-operatória e tosse pós-operatória em diferentes intervalos de tempo.

Resultados

No período de 2 horas, o Grupo D apresentou maior número de pacientes sem sintomas de POST (92,59%) comparado ao Grupo K (74,07%) e ao Grupo N (67,41%) (p < 0,0001). Da mesma forma, mais pacientes do Grupo D não apresentaram rouquidão (93,33%) e tosse pós-operatória (93,33%) nesse mesmo período. Além disso, o Grupo D demonstrou consistentemente a menor incidência de POST, rouquidão pós-operatória e tosse pós-operatória em todos os intervalos avaliados.

Conclusão

A dexametasona intracuff parece ser uma intervenção favorável para o alívio dos sintomas de POST, rouquidão pós-operatória e tosse pós-operatória no período inicial pós-cirúrgico.

Número de registro do ensaio clínico: CTRI/2022/08/044,664

Supplementary materials: Material suplementar associado a este artigo pode ser encontrado na versão online em doi: 10.1016/j.bjane.2025.844651.

Palavras-chave

Tosse; Dexametasona; Rouquidão; Cetamina; Dor; Pós-operatório

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Submitted date:
12/23/2024

Accepted date:
06/08/2025