Comparing the Effect of Dexamethasone before and after Tracheal Intubation on Sore Throat after Tympanoplasty Surgery: A Randomized Controlled trial

Document Type : Original

Authors

1 Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Department of Otorhinolaryngology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Department of Anesthesiology, School of Para Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

4 Department Otorhinolaryngology School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

5 School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction:
Presence of a sore throat after surgery is a common side effect of general anesthesia with intratracheal intubation and can cause discomfort for the patient and prolong the recovery process. In this study we compared the effect of dexamethasone before and after intubation on the incidence of sore throat after tympanoplasty surgery.
 
Materials and Methods:
In a double-blind, randomized clinical trial, 70 patients aged 30–60 years with American Society of Anesthesiologists (ASA) physical status I or II who were candidates for tympanoplasty under anesthetic conditions were studied in two separate groups. The first group received intravenous (IV) dexamethasone (8 mg) 30 mins prior to intubation while the second group received the same dose of dexamethasone 30 mins after intubation. The incidence and severity of the sore throat in both groups were then evaluated.
 
Results:
There was no significant difference between two groups in intensity of sore throat (62.9% vs. 57.1%), cough (65.7% vs. 62.9%), or hoarseness (62.9% vs. 65.7%) within 24 h after surgery. Detection of blood in oral secretions or on the tracheal tube was the same in both groups (5.7%). The incidence of coughs during the extubation was 0% in first group and 11.4% in second group.
 
Conclusion: 
According to the results of this research there was no significant difference in incidence and intensity of sore throat in patients receiving dexamethasone before or after intubation. Further, no significant difference in intensity of coughs or hoarseness was observed.
 

Keywords


1. Tasar A, Yanturali S, Topacoglu H, Ersoy G, Unverir P, Sarikaya S. Clinical efficacy of dexamethasone for acute exudative pharyngitis. J Eng Med 2008; 35(4): 363-7.
2. Mchardy FE, Chung F. Postoperative sore throat: Cause, prevention and treatment.Anesthesia 1999; 54(5): 444-53.
3. Peppard SB, Dickens JH. Laryngeal injury following shortterm intubation. Annals of Otology, Rhinology and Laryngology 1983; 92(4pt1):     327–30.
4. Thomas S, Beevi S. Dexamethasone reduces the severity of postoperative sore throat. Can. J.Anaesth2007; 54(11): 897-901.
5. Park SH, Han 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 Analg2008; 107(6): 1814-18.
6. Christensen AM, Willemoes-Larsen H, Lundby L, Jakobsen KB. Postoperative throat complaints after trachealintubation. British Journal of Anaesthesia 1994; 73(6): 786–7.
7. Harding CJ, McVey FK. Interview method affects incidence of postoperative sore throat. Anaesthesia 1987; 42(10): 1104–7.
 8. Tabari M, Soltani G, Zirak N, Alipour M, Khazaeni K. Comparison of Effectiveness of Betamethasone gel Applied to the Tracheal Tube and IV Dexamethasone on Postoperative Sore Throat: A Randomized Controlled Trial. Iranian Journal of Otorhinolaryngology 2013; 25(4): 215-19.
9. Hayward G, Thompson M, Henghan C, Perea R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat. BMJ 2009; 339: 2976-80.
10. Park SY, Kim SH, Lee A, Cho SH, Chae Ws, Jan Hc, et al. Prophylactic effect of dexamethasone in reducing postoperative sorethroat. korean J Anesthesiol 2010; 58(1): 15-19.
11. Melzack R. The short-form McGill Pain Questionnaire. Pain 1987; 30(2):191–7.
12. Adrianna C. Shembel MA, Clark A, Thomas G, Jackie L.  Development and validation of the cough severity index: A severity index for chronic cough related to the upper airway. Laryngoscope 2013; 123(8): 1931-36.
13. Wang JJ, Ho ST, Lee SC, Liu YC, Liu YH, Liao YC. The prophylactic effect of dexamethasone on postoperative nausea and vomiting in women undergoing thyroidectomy: a comparison of droperidol with saline. Anesth Analg 1999; 89:   200–3.