Comparison between betamethasone gel applied over endotracheal tube and ketamine gargle for attenuating postoperative sore throat, cough and hoarseness of voice.

BACKGROUND: Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa resulting in postoperative sore throat, hoarseness of voice and cough. The aim of this study was to evaluate two different methods as regard their efficacy for controlling the postoperative pharyngo-laryngo-tracheal sequelae (sore throat, cough, hoarseness of voice) after general anesthesia with laryngoscopy and tracheal intubation. We compared between the effects of betamethasone gel applied over the endotracheal tube and gargling with ketamine solution in reducing these complications during the first 24 postoperative hours after elective surgical procedures in a prospective randomized controlled single blind clinical trial.

METHODS: Seventy five patients ASA physical status I and II, undergoing elective surgery under general anesthesia using endotracheal intubation were enrolled in this prospective, randomized, single-blind study. Patients were randomly divided into 3 groups of 25 patients each: Group (K): (n: 25) Patients in this group were asked to gargle with ketamine 40 mg in 30 ml saline for 60 seconds as repeated smaller attempts, 5 minutes before induction of anesthesia. Group (B) (n: 25): Endotracheal tubes were lubricated with 0.05% betamethasone gel. Group (C) (n: 25):

CONTROL GROUP: patients did not receive ketamine gargle nor betamethasone gel. The incidence and the severity of Postoperative sore throat, cough, and hoarseness of voice were graded at 0, 2, 4, and 24 h after operation by a blinded investigator.

RESULTS: The incidence and severity of sore throat were significantly lower in group (K) and group (B) than group (C) (p < 0.05) at all time intervals. While there was no significant difference between group (K) and group (B) (p > 0.05). The incidence and severity of cough and hoarseness of voice were significantly lower in group (B) than group (C) and group (k) (p < 0.05) at all time intervals.

CONCLUSION: Gargling with ketamine before induction of anesthesia is comparable with application of 0.05% betamethasone gel over the Endotracheal tubes in decreasing postoperative sore throat. In addition, Betmethasone application decreased the incidence and severity of postoperative cough and hoarsness of voice.