Post Operative Sore Throat and Dexamethasone
Condition: Sore Throat; Pain
MeSH terms: Pharyngitis
Study type: Interventional
Phase: Phase 4

Summary: 
      Sore throat is a common postoperative complaint that can lead to morbidity and patient
      dissatisfaction . The incidence of sore throat has been reported to be between 6% and 90%
      even under optimal intubating conditions. There are several factors that have been shown to
      contribute to postoperative sore throat such as patient related factors, type of anesthesia
      and type of surgery.

      Corticosteroids are also commonly used in the perioperative period to potentiate analgesics
      and as antiemetics. The preoperative administration of dexamethasone can decrease the
      incidence and severity of postoperative sore throat which is rated by patients as one of the
      most undesirable outcomes in the postoperative period.
    

Detailed description: 
      Sore throat is a common postoperative complaint that can lead to morbidity and patient
      dissatisfaction. The incidence of sore throat has been reported to be between 6% and 90% even
      under optimal intubating conditions. There are several factors that have been shown to
      contribute to postoperative sore throat such as patient related factors, type of anesthesia
      and type of surgery. It has been observed that gargle with azunol reduced the incidence of
      postoperative sore throat from 65% to 25 %. Similarly, a reduction in sore throat following
      tracheal intubation from 78% to 40 % has been reported after gargle with ketamine performed 5
      minutes before induction of anesthesia. More recently, it was also demonstrated that
      preoperative gargle with licorice resulted in a 57 percent reduction of the absolute risk of
      sore throat after intubation. Although the gargling technique has been shown to be successful
      in decreasing the incidence of postoperative sore throat, it has a limited feasibility
      because the volumes administered could increase the chance of aspiration if ingested and it
      may be difficult to perform in sedated patients and in children.

      Tracheal intubation is associated with an increase of polymorphonuclear cells in the tracheal
      tissue and plasma levels of interleukin 6, suggesting an inflammatory response to the
      presence of the endotracheal tube itself or to some aspect of the intubation process.
      Dexamethasone is widely prescribed for the treatment of a sore throat resulting from tracheal
      mechanical irritation due to its modulating effects of tissue edema and pain. Moreover,
      prophylactic dexamethasone has been shown to be effective in reducing the frequency of airway
      obstruction in patients at high risk for laryngeal edema following extubation. It decreases
      postoperative sore throat in patients requiring double-lumen tubes.

      Dexamethasone has been shown to decrease postoperative sore throat in patients requiring
      hospital admission but it has not been evaluated in the ambulatory setting. Ambulatory
      patients usually need to return to work faster than patients who are admitted to the
      hospital. Their ability to tolerate fluids and food might help them to return to normal
      living. They also have smaller surgeries which might increased their perception to sore
      throat pain when compared to bigger, more painful procedures.

      Possible side effects of corticosteroids such as retardation of wound healing, susceptibility
      to infection and gastrointestinal hemorrhage have not been noted with short term use (<24
      hours ) in surgical patients. Corticosteroids are also commonly used in the perioperative
      period to potentiate analgesics and as antiemetics.
    

Intervention name(s): Placebo administration; Dexamethasone 0.05mg/kr administration; Dexamethasone 0.1mg/kg
Intervention type(s): Drug; Drug; Drug
Intervention description(s): Placebo administration; Dexamethasone 0.05mg/kr administered in 100ml of sterile saline solution prior to the start of surgery.; Dexamethasone 0.1mg/kg administered in 100ml of sterile saline solution prior to the beginning of surgery.
Other intervention name(s): Decadron; Corticosteroid; Decadron; corticosteroid; Decadron; corticosteroid
Intervention MeSH terms: Dexamethasone; Dexamethasone acetate; BB 1101
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Sore throat; Dexamethasone; Pain