A COMPARISON OF EFFECT OF NEBULISED KETAMINE AND NEBULISED MAGNESIUM SULPHATE IN REDUCTION OF INCIDENCE AND SEVERITY OF POSTOPERATIVE SORE THROAT - A PROSPECTIVE RANDOMIZED DOUBLE BLINDED STUDY
Authors: Annie Geeta M. Selvi , Ram M. Ramesh 
Published: November 2021

Introduction: Postoperative sore throat (POST) is a common occurrence following general anesthesia
with endotracheal intubation. The incidence of POST is estimated to be 21%-65% in various studies.
Irritation and inammation of the air way are considered to be the cause of POST. Although considered a minor and self limiting
complication, it may cause a signicant patient morbidity, dissatisfaction and increased the length of duration of hospital stay.
Various pharmacological and non pharmacological methods have been tried to decrease POST with varying success rates.
Among the interventions, the use of ketamine gargle or lozenges has highest success rates, but the problem with this is the bitter
taste of the drug and the risk of aspiration, so aerosol route of drug administration gained popularity among the
anesthesiologists with good acceptance from the patients. It is known that N-methyl-D-aspartate (NMDA) receptors have a role
in nociception and inammation. Hence, this study is aimed at using the aerosol route of magnesium sulphate and ketamine
and to nd it effectiveness in preventing POST.
Aim Of The Study: To evaluate the effect of nebulized ketamine and nebulized magnesium sulphate for attenuation of
postoperative sore throat in patients undergoing surgeries under general anesthesia with tracheal intubation.
Materials And Methods: This study was done in the Department of Anesthesiology in collaboration with the Department of
Surgery in Kanyakumari Government Medical College from January 2019 to December 2019. Patient planned for surgery under
general anesthesia except head, neck & ENT surgeries were selected and randomized into two groups (35 each). Each group
received nebulisation for 15 min before induction of general anaesthesia. Group M: Nebulization with 500mg magnesium
sulphate in 5ml NS. Group K: Nebulization with 50mg ketamine in 5ml NS. The Parameters related to the study such as duration
of laryngoscopy, time taken to intubate, duration of surgery, number of attempts to intubate were recorded. Incidence and
severity of sore throat were assessed by four point scale. Incidence of sore throat is assessed for 24 hours. Complication were
recorded.
Results: We found that the demographic parameters were comparable and statistically insignicant. The mean duration of
laryngoscopy difference between the two groups Group M - 24.54± 1.12 seconds and Group K - 24.49 ±1.15 seconds was not
statistically signicant P= 0.834 (P>0.05). The mean time taken to intubate in Group M - 27.54± 1.12 seconds and Group K -
27.54± 1.12 seconds was not statistically signicant with P=1.000 respectively (P>0.05). The mean duration of surgery in
Group M - 90.71±15.67 minutes and the Group K - 88.20 ±16.53 minutes between the two groups was not statistically signicant
P= 0.516 (P>0.05). The mean difference of number of attempts taken to intubate between the two groups was statistically
insignicant P=0.771 (P>0.05). The overall incidence of sore throat in Group M was 91% and in Group B was 34%. The severity
of sore throat between Group M and Group K is statistically signicant at 2, 4, 6 hrs at grade 1 and grade 2.
Conclusion: On the basis of our result, we can suggest that the use of perioperative ketamine nebulization when compared
magnesium sulphate nebulization reduces the incidence and severity of post-operative sore throat at 4th and 6th hour during
postoperative period in patients who had received general anesthesia with tracheal intubation.