Comparison Prophylactic Effects of Gargling Different Doses of Ketamine on Attenuating Postoperative Sore Throat: A Single‑Blind Randomized Controlled Trial

Dorna Kheirabadi, Maryam Sobhan Ardekani, Azim Honarmand, Mohammad Reza Safavi, Elnaz Salmasi

Abstract


Context: Postoperative sore throat (POST) is a common annoying problem following endotracheal (ET) intubation. Aims: Comparing the impact of low and high doses of ketamine gargle on lowering POST incidence and severity. Settings and Design: 96 patients selected for septoplasty surgery under general anesthesia were investigated through a single‑blind randomized controlled trial.

Methods: This study was performed on three equal groups. Group K and G gargled 50 and 100 mg ketamine, respectively, solved in normal saline and group C gargled pure normal saline for 30 s at 5 min before tracheal intubation. POST severity measured immediately after the entrance to the postanesthetic care unit (PACU) and then 2 h, 4 h, 8 h, and 24 h after operation. Statistical Analysis Used: Collected data were analyzed by the Chi‑square test, Mann‑Whitney test, Kruskal‑Wallis test, one‑way analysis of variance (ANOVA) and Friedman test using SPSS version 20.

Results: POST incidence and severity in group C were significantly higher than both K and G groups at all times. Although significant differences between low and high doses of ketamine were acknowledged at 8 h post‑operation, 100 mg ketamine could attenuate POST severity further than 50 mg at all times.

Conclusions: It seems that 100 mg outperformed 50 mg ketamine without rising complications and dissatisfaction for subjects. So, it gives us a powerful reason to suggest gargling 100 mg ketamine for lessening POST incidence and severity


Keywords


Gargle; ketamine; pharyngitis

Full Text:

PDF

References


Liu J, Zhang X, Gong W, Li S, Wang F, Fu S, et al. Correlations

between controlled endotracheal tube cuff pressure and post

procedural complications: A multicentre study. Anesth Analg

;111:1133‑7.

Safavi SM, Honarmand A, Fariborzifar A, Barvarz S,

Soleimani M. Intravenous dexamethasone vs. ketamine gargle

vs. intravenous dexamethasone combined with ketamine gargle

for evaluation of post‑operative sore throat and hoarseness:

A randomized, placebo‑controlled, double‑blind clinical trial.

J Isfahan Med Sch 2013;31:933‑43.

Solatpour F, Teymourian H, Mohajerani SA, Hoseinzadegan Shirazi F,

Lotfollah Zadeh S, Baikpour M, et al. Comparison of the incidence

of sore throat after rapid sequence intubation with succinylcholine

and cisatracurium. Anesth Pain Med 2014;4:e20030.

Ogata J, Minami K, Horishita T, Shiraishi M, Okamoto T,

Terada T, et al. Gargling with sodium azulene sulfonate reduces

the postoperative sore throat after intubation of the trachea.

Anesth Analg 2005;101:290‑3.

Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U.

Ketamine gargle for attenuating postoperative sore throat. Br J

Anaesth 2008;100:490‑3.

Tanaka Y, Nakayama T, Nishimori M, Sato Y, Furuya H.

Lidocaine for preventing postoperative sore throat. Cochrane

Database Syst Rev 2009:CD004081.

Sumathi PA, Shenoy T, Ambareesha M, HM K. Controlled

comparison between betamethasone gel and lidocaine jelly

applied over tracheal tube to reduce postoperative sore throat,

cough, and hoarseness of voice. Br J Anaesth 2008;100:215‑8.

Heidari SM, Sabzeali M. Preemptive effect of pethidine,

ketamine and ondansetron on post‑operative shivering in

patients undergoing abdominal surgery with general anaesthesia.

J Isfahan Med Sch 2016;34:90‑7.

Carlton SM, Zhou S, Coggeshall RE. Evidence for the interaction

of glutamate and NK1 receptors in the periphery. Brain Res

;790:160‑9.

Rudra A, Ray S, Chatterjee S, Ahmed A, Ghosh S. Gargling

with ketamine attenuates the postoperative sore throat. Indian J

Anaesth 2009;53:40‑3.

Aigbedia SO, Tobi KU, Amadasun FE. A comparative study of

ketamine gargle and lidocaine jelly application for the prevention

of postoperative throat pain following general anaesthesia with

endotracheal intubation. Niger J Clin Pract 2017;20:677‑85.

Teymourian H, Mohajerani SA, Farahbod A. Magnesium and

ketamine gargle and postoperative sore throat. Anesth Pain Med

;5:22367.

Doukumo DM, Faponle AF, Bolaji BO, Adenekan AT,

Olateju SOA. Effects of lidocaine and KY jellies on sore throat,

cough and hoarseness following endotracheal anaesthesia. J West

Afr Coll Surg 2012;8:1‑13.

Chan L, Lee ML, Lo YL. Postoperative sore throat and ketamine

gargle. Br J Anaesth 2010;105:97.

Hadavi M, Rezaeian M. The efficacy of ketamine gargles on

postoperative sore throat. Zahedan J Res Med Sci (ZJRMS)

;13:12‑6.




ijpm_12_448