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International Journal of Biomedical Innovations and Engineering Review Article

Impact of Pre-Operative Nebulized Lidocaine–Dexmedetomidine Combination Versus Monotherapy on Incidence, Severity, and Patient Comfort Scores of Post-Operative Sore Throat: A Randomized Controlled Clinical Trial

  1. Pratul Department of Anesthesia, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala
  2. Masrata Gull Department of Radiology, Dolphin PG College, Chunni
  3. Abhishek Department of Anesthesia, Rayat Bahra University, Mohali

Abstract

Post-operative sore throat (POST) is a common issue after endotracheal intubation and can reduce patient comfort and hinder recovery. This randomized, double-blind clinical study investigated how effective pre-operative nebulized lidocaine, dexmedetomidine, and their combination are in minimizing POST. Eligible adult patients classified as ASA I–II and scheduled for elective surgery under general anesthesia were randomly assigned to three groups. Nebulization was administered 15–20 minutes before induction using standardized dosing and uniform anesthesia protocol. The primary outcome was incidence of POST within 24 hours. Secondary outcomes included severity grading, patient comfort scores, and associated airway complications. The combination group demonstrated a significantly lower incidence and severity of POST compared to monotherapy groups. Patient comfort scores were consistently improved with combination therapy. Airway-related complications, such as hoarseness and cough, were also reduced. Pre-operative nebulized lidocaine–dexmedetomidine appears to be an effective strategy for minimizing postoperative airway morbidity.

Keywords

References (20)

  1. McHardy FE, Chung F. Postoperative sore throat: Cause, prevention and treatment. Anaesthesia. 1999;54(5):444–53.
  2. El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: A systematic review. Anaesthesia. 2016;71(6):706–17.
  3. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582–4.
  4. Jaensson M, Gupta A, Nilsson UG. Risk factors for development of postoperative sore throat and hoarseness after endotracheal intubation. J Clin Anesth. 2012;24(8):567–73.
  5. Combes X, Schauvliege F, Peyrouset O, Motamed C, Kirov K, Dhonneur G, et al. Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology. 2001 Nov;95(5):1120–1124. doi:10.1097/00000542-200111000-00014.
  6. Navarro LHC, Lima RM, Aguiar AS, Braz JRC, Carness JM, Módolo NSP. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers. Rev Assoc Med Bras (1992). 2012 Mar-Apr;58(2):248–253. doi:10.1590/S0104-42302012000200025.
  7. Ahuja V, Mitra S, Sarna R. Nebulized ketamine decreases incidence and severity of postoperative sore throat. Anesth Essays Res. 2015;9(1):37–42.
  8. Borazan H, Kececioglu A, Okesli S, Otelcioglu S. Oral Magnesium Lozenge Reduces Postoperative Sore Throat. Anesthesiology. 2012;117(3):512-518. doi:10.1097/aln.0b013e3182639d5f
  9. Park SY, Kim SH, Lee AR, Cho SH, Chae WS, Jin HC, et al. Prophylactic effect of dexamethasone in reducing postoperative sore throat. Korean Journal of Anesthesiology. 2010;58(1):15. doi:10.4097/kjae.2010.58.1.15
  10. Abdel-Ghaffar HS, Kamal SM, El Sherif FA, Mohamed SA. Comparison of nebulised dexmedetomidine, ketamine, or midazolam for premedication in preschool children undergoing bone marrow biopsy. British Journal of Anaesthesia. 2018;121(2):445-452. doi:10.1016/j.bja.2018.03.039
  11. Grewal A. Dexmedetomidine: New avenues. J Anaesthesiol Clin Pharmacol. 2011;27(3):297–302.
  12. Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. Anaesthesia. 1999;54(2):146–65.
  13. Memiş D, Hekimoğlu S, Vatan İ, Yandım T, Yüksel M, Süt N. Effects of midazolam and dexmedetomidine on inflammatory responses and gastric intramucosal pH to sepsis, in critically ill patients. British Journal of Anaesthesia. 2007;98(4):550-552. doi:10.1093/bja/aem017
  14. Tanaka Y, Nakayama T, Nishimori M, Tsujimura Y, Kawaguchi M, Sato Y. Lidocaine for preventing postoperative sore throat. Cochrane Database of Systematic Reviews. 2015;2015(7). doi:10.1002/14651858.cd004081.pub3
  15. Hu B, Bao R, Wang X, Liu S, Tao T, Xie Q, et al. The Size of Endotracheal Tube and Sore Throat after Surgery: A Systematic Review and Meta-Analysis. PLoS ONE. 2013;8(10):e74467. doi:10.1371/journal.pone.0074467
  16. Takahashi S, Mizutani T, Miyabe M. Effect of tracheal tube cuff pressure on postoperative sore throat. Anesthesiology. 2000;92(2):377–81.
  17. Liu Y, Ai D, Wang X. Efficacy of perioperative intravenous dexmedetomidine administration for the prevention of postoperative sore throat: a meta-analysis. Journal of International Medical Research. 2021;49(5). doi:10.1177/03000605211017686
  18. Kuriyama A, Maeda H, Sun R. Topical lidocaine for prevention of postoperative sore throat. Anesth Analg. 2019;129(3):720–7.
  19. Mostafa RH, Saleh AN, Hassan AM. Nebulized lidocaine versus dexmedetomidine for prevention of postoperative sore throat. Ain-Shams J Anaesthesiol. 2020;12(1):18.
  20. Singh NP, Makkar JK, Wadhwa A, Gombar S, Wig J, Kumar B. Comparison of nebulized dexmedetomidine and ketamine for prevention of postoperative sore throat after general anesthesia with endotracheal intubation. Indian J Anaesth. 2021;65(5):373–379. doi:10.4103/ija.