Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparing the Prophylactic Effect of Two Different Methods of Administration of Dexamethasone (Intracuff and Intravenous) on Postoperative Sore Throat and Cough

Document Type : Original Article (s)

Authors
Mitra Jabalameli 1
Reyhanak Talakoub 2
Shima Shalil-Ahmadi 3
1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v36i512.10616
Abstract
Background: Of the most common complications occur after anesthesia with intubation is postoperative sore throat, coughing after extubation, and hoarseness. Today, the use of dexamethasone before surgery is effective in controlling these complications. Therefore, the purpose of this study was to compare the prophylactic effect of two different methods of administration of dexamethasone (intracuff and intrsvenous) on sore throat and cough after surgery.Methods: In this clinical trial study, 96 patients undergoing general anesthesia and intubation were randomly assigned into three groups. The first group received 4 mg intravenous dexamethasone, the second group received 4 mg intracuff dexamethasone, and the third group received placebo. The frequency of cough and the severity of a sore throat were evaluated in three groups.Findings: There was no significant difference between the three groups based on hemodynamic variables (P > 0.05), but the cough rate in the first and second groups was significantly lower than the control group (P < 0.01). Moreover, the mean of the severity of sore throat in recovery and 1 hour after surgery in the first and second groups were significantly lower than the control group (P < 0.01). However, there was no difference between the groups based on the severity of sore throat within 24 hours after surgery (P > 0.05).Conclusion: Using intravenous and intracuff dexamethasone before surgery can reduce the amount of cough and the severity of sore throat in patients.
Keywords
Dexamethasone
Intravenous injections
Cough
Pharyngitis
  1. Kalil DM, Silvestro LS, Austin PN. Novel preoperative pharmacologic methods of preventing postoperative sore throat due to tracheal intubation. AANA J 2014; 82(3): 188-97.
  2. Park SY, Kim SH, Lee AR, Cho SH, Chae WS, Jin HC, et al. Prophylactic effect of dexamethasone in reducing postoperative sore throat. Korean J Anesthesiol 2010; 58(1): 15-9.
  3. Tanaka Y, Nakayama T, Nishimori M, Sato Y, Furuya H. Lidocaine for preventing postoperative sore throat. Cochrane Database Syst Rev 2009; (3): CD004081.
  4. D'Aragon F, Beaudet N, Gagnon V, Martin R, Sansoucy Y. The effects of lidocaine spray and intracuff alkalinized lidocaine on the occurrence of cough at extubation: a double-blind randomized controlled trial. Can J Anaesth 2013; 60(4): 370-6.
  5. Maruyama K, Sakai H, Miyazawa H, Toda N, Iinuma Y, Mochizuki N, et al. Sore throat and hoarseness after total intravenous anaesthesia. Br J Anaesth 2004; 92(4): 541-3.
  6. Lee SH, Lee YC, Lee JH, Choi SR, Lee SC, Lee JH, et al. The prophylactic effect of dexamethasone on postoperative sore throat in prone position surgery. Korean J Anesthesiol 2016; 69(3): 255-61.
  7. Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg 1999; 89(3): 652-8.
  8. Agarwal A, Gupta D, Yadav G, Goyal P, Singh PK, Singh U. An evaluation of the efficacy of licorice gargle for attenuating postoperative sore throat: A prospective, randomized, single-blind study. Anesth Analg 2009; 109(1): 77-81.
  9. Takekawa K, Yoshimi S, Kinoshita Y. Effects of intravenous lidocaine prior to intubation on postoperative airway symptoms. J Anesth 2006; 20(1): 44-7.
  10. Choubsaz M, Amirifard N, Sadeghi M, Sadeghi E, Johari Z. The effect of adding dexamethasone to intracuff lidocaine 2% on decreasing the respiratory complications after general anesthesia: a randomized, double blind, clinical trail. J App Pharm Sci 2016; 6(5): 152-5.
  11. Safavi M, Honarmand A, Fariborzifar A, Attari M. Intravenous dexamethasone versus ketamine gargle versus intravenous dexamethasone combined with ketamine gargle for evaluation of post-operative sore throat and hoarseness: A randomized, placebo-controlled, double blind clinical trial. Adv Biomed Res 2014; 3: 212.
  12. Thomas S, Beevi S. Dexamethasone reduces the severity of postoperative sore throat. Can J Anaesth 2007; 54(11): 897-901.
  13. Park SH, Han SH, Do SH, Kim JW, Rhee KY, Kim JH. Prophylactic dexamethasone decreases the incidence of sore throat and hoarseness after tracheal extubation with a double-lumen endobronchial tube. Anesth Analg 2008; 107(6): 1814-8.
  14. Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anesth 2002; 14(1): 15-8.
  15. Rafiei MR, Arianpour N, Rezvani M, Ebrahimi A. Effects of intracuff dexamethasone on post-extubation reactions. J Res Med Sci 2012; 17(4): 338-43.
  16. Bagchi D, Mandal MC, Das S, Sahoo T, Basu SR, Sarkar S. Efficacy of intravenous dexamethasone to reduce incidence of postoperative sore throat: A prospective randomized controlled trial. J Anaesthesiol Clin Pharmacol 2012; 28(4): 477-80.
  17. Haider HS, Al-Ali BT. The role of dexamethasone in reducing the severity of postoperative sore Throat. The Iraqi Postgraduate Medical Journal 2013; 12(3): 454-9.
  18. Ruangsin S, Wanasuwannakul T, Pattaravit N, Asim W. Effectiveness of a preoperative single dose intravenous dexamethasone in reducing the prevalence of postoperative sore throat after endotracheal intubation. J Med Assoc Thai 2012; 95(5): 657-60.
  19. Kep Kee W, Nadia MN, Melvin K, Muhammad M, Raha AR, Nurlia Y. Post-intubation airway related adverse effects: A comparison between intra-cuff dexamethasone and intra-cuff alkalinized lignocaine. Journal of Surgical Academia 2013; 3(2): 26-31.
Journal of Isfahan Medical School
Volume 36, Issue 512 - Serial Number 512
November and December 2019
Pages 1648-1654

  • Receive Date 08 August 2018
  • Accept Date 06 April 2022