Journal of Isfahan Medical School

Journal of Isfahan Medical School

Evaluation of the Effect of Three Different Doses of Intranasal Dexamethasone in Preventing Postoperative Sore Throat in Patients Under General Anesthesia Requiring Endotracheal Intubation

Document Type : Original Article(s)

Authors
,Amir Shafa 1
Hamidreza Shetabi 2
Zeinab Kheradmand Rad 3
1 Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v44.i872.1348
Abstract
Background: Postoperative sore throat is a common complication following endotracheal intubation during general anesthesia. Dexamethasone has analgesic properties that are effective in reducing postoperative sore throat. Building on a previous study of 8 mg intranasal dexamethasone, the present study simultaneously compared 6, 8, and 10 mg doses to examine between-dose differences and a possible dose-related pattern.
Methods: This study included 100 patients who were candidates for ophthalmologic surgery. Participants were randomly divided into four groups of 25 patients. One group received 6 mg, one group received 8 mg, one group received 10 mg of intranasal dexamethasone, and one group received intranasal normal saline. Symptoms of sore throat, cough, and hoarseness were recorded after surgery and analyzed. The primary outcome was the incidence of postoperative sore throat; cough and hoarseness were secondary outcomes.
Findings: No statistically significant between-group differences were observed in baseline demographic characteristics, tracheal-intubation-related variables, or duration of surgery. In unadjusted time-specific analyses, the dexamethasone groups had lower incidences of sore throat, cough, and hoarseness from recovery through 6 hours. In a sensitivity analysis applying Holm–Bonferroni correction to the 18 outcome-by-time tests, sore throat remained significant only at 6 hours (adjusted P = 0.028), hoarseness remained significant at the four early time points (adjusted P < 0.018), and no cough comparison remained significant.
Conclusion: A decreasing percentage of sore-throat incidence was observed with increasing intranasal dexamethasone dose; however, a formal trend analysis across the three active doses did not remain significant after multiplicity correction and therefore does not establish a dose-response relationship. After conservative multiplicity adjustment, the more robust statistical evidence was mainly limited to sore throat at 6 hours and early postoperative hoarseness. These results should be interpreted cautiously because within-patient repeated measurements were not modeled longitudinally.

Highlights

Zeinab Kheradmand Rad: Google Scholar

Amir Shafa: Google Scholar

Hamidreza Shetabi: Google Scholar

Keywords
Intranasal dexamethasone
Sore throat
Endotracheal intubation
Ophthalmologic surgery
Cough
Subjects
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Journal of Isfahan Medical School
Volume 44, Issue 872
4th Week, September
September and October 2026
Pages 1348-1357

  • Receive Date 10 August 2026
  • Revise Date 02 September 2026
  • Accept Date 08 September 2026