Preoperative Gum Chewing for Different Durations to Prevent Sore Throat After Endotracheal Intubation
Condition: Gum Chewing; Sore Throat; Endotracheal Intubation; Randomized Controlled Trial
MeSH terms: Pharyngitis
Study type: Interventional

Summary: 
      This study aims to evaluate the effect preoperative chewing gums for 2 or 4 minutes on
      postoperative sore throat after general anesthesia using an endotracheal tube.
    

Detailed description: 
      Pharmacological measures for attenuating postoperative sore throat (POST) include inhalation
      of beclomethasone or fluticasone propionate; gargling with azulene sulfonate, aspirin, or
      ketamine: gargling or spraying benzydamine hydrochloride; intravenous (IV) dexamethasone;
      oral clonidine; topical or systemic lidocaine; and ingestion of strepsils tablets. Each of
      these approaches has limitations and variable success rates; thus, no approach has become
      established in routine clinical use. In the past decade, studies have shown that xylitol in
      chewing gum may inhibit the growth, metabolism, and polysaccharide production of
      Streptococcus mutans, which accounts for the highest proportion of the natural flora in the
      oral cavity. Subsequent biofilm formation reduction may lead to some reduction in the number
      of bacteria. Furthermore, chewing gum can promote salivary gland secretion, resulting in
      lubrication and cleansing of the oral cavity. which may decrease postoperative sore throat.

      Patients included in the study will be divided into 3 groups; the gum group2 (group G2), the
      gum group4 (group G4) and the control group (group C) by a computer-generated random number
      table before surgery. In the preoperative waiting area before transfer to the operating room,
      patients in group G2 will chew 1 piece of herbal sugar-free for 2 minutes and then spat it
      out, patients in group G4 will chew 1 piece of herbal sugar-free for 4 minutes and then spat
      it out, group C will be asked to swallow 2 times only. After entering to the OR patients will
      be routinely monitored with ECG, Pulse oximetry, and blood pressure then induction of
      anesthesia will be done using Fentanyl 1 to 2 mcg per kg, propofol 1 to 3 mg per kg, and
      atracurium 0.6 mg per kg. endotracheal tube size 7.5 will be inserted. volume-controlled
      ventilation was initiated with a mixture of 50% oxygen and 50% air, a respiratory rate of 12
      cycles·minute, an inspiratory-to-expiratory ratio (I:E) of 1:2 and an adjusted end-tidal CO2
      maintained at approximately 35-40 mm Hg. Ondansetron (4 mg) and paracetamol 1g were injected
      IV to prevent postoperative nausea, vomiting, and pain. Patients will be extubated after
      being awake using minimal suction. Postoperative sore throat (POST) will be evaluated by the
      numerical rating scale (NRS), which ranges from 0 to 10 points, with 0 indicating no pain,
      1-3 indicating mild discomfort, 4-6 indicating moderate pain, and 7-10 indicating severe
      pain.
    

Intervention name(s): Gum chewing for 2 minutes; Gum chewing for 4 minutes
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): In the preoperative waiting area before transfer to the operating room, patients will chew 1 piece of herbal sugar-free for 2 minutes and then spat it out.; In the preoperative waiting area before transfer to the operating room, patients will chew 1 piece of herbal sugar-free for 4 minutes and then spat it out.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patients included in the study will be divided into 3 groups; the gum group2 (group G2), the gum group4 (group G4) and the control group (group C) by a computer-generated random number table before surgery.
Masking: None (Open Label)
Primary purpose: Prevention