The Effect of Betamethasone Gel and Lidocaine Jelly Applied Over Tracheal Tube Cuff on Postoperative Sore Throat, Cough, and Hoarseness.

PURPOSE: The purpose of the study was to investigate the effect of betamethasone gel and lidocaine jelly (over tracheal tube cuff) compared with distilled water on the postextubation syndrome incidence (sore throat, cough, and hoarseness). DESIGN: Double-blind randomized clinical trial study was used. METHODS: Ninety-nine patients of either sex undergoing elective surgery, under general anesthesia with endotracheal intubation, were recruited. Patients were randomized into three group, betamethasone gel, lidocaine jelly, or distilled water applied on the external surface of the tracheal tube. Patients were assessed for postoperative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery. FINDINGS: In the first hour after surgery, the patients who received lidocaine or betamethasone had a significantly greater incidence of sore throat than the patients who received distilled water (RR = 2.9). In the sixth hour after surgery, there was a better effect of distilled water on reducing the incidence of sore throat, but no significant differences between the three groups were seen 24 hours after surgery. The incidence of cough was significantly lower in the distilled water group (P < .02) except at the first and 24 hours postoperative when the incidence of cough was similar. The incidence of hoarseness was similar between the three groups at 1, 6, and 24 hours after surgery. CONCLUSION: In this study, the use of lidocaine gel and betamethasone does not reduce the incidence of sore throat or cough after intubation as much as distilled water.

The effect of endotracheal tube cuff pressure control on postextubation throat pain in orthognathic surgeries: a randomized double-blind controlled clinical trial.

Pain in the throat after extubation is one of the most common complaints after maxillofacial operations under general anaesthesia. We have evaluated the amount of pain after extubation when we controlled the pressure in the endotracheal cuff during operation by analysing the records of 43 patients who had maxillofacial operations under general anaesthesia. In the study group (n=20) the cuff pressure of the endotracheal tube was adjusted using a pressure gauge at the beginning of intubation and every hour during operation. In the control group (n=23), an experienced anaesthetist adjusted the pressure only at the beginning of the operation by palpating the pilot balloon. Throat pain was evaluated 1, 6, and 24h postoperatively on a visual analogue scale (VAS), and the pain scores in the control and study groups postoperatively was 5.3 (1.1) compared with 3.9 (1.5) (p=0.002); 4.5 (1.3) compared with 3.1 (1.5) (p=0.002); and 1.9 (1.1) compared with 1.6 (1.2) (p=0.4), respectively. The differences between the two groups at 1h and 6h postoperatively were significant, but that at 24h was not. Control of the cuff pressure of the endotracheal tube with a gauge at the beginning of the operation, and adjustment of the pressure during operation, can reduce postoperative complications such as throat pain.