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Background: Laryngoscopy and tracheal intubation lead to sympathetic stimulation resulting in hemodynamic fluctuations. We compared local anesthetic ropivacaine 0.75% with alpha agonist dexmedetomidine through ultrasonic nebulization for direct local action of the drug in the airway. Methods: In our randomized study, 180 patients were prospectively assigned to three groups of 60 each: group R (0.75%), group D (1 microgram/kg), and group C (control). The primary objective was to determine whether nebulized ropivacaine or nebulized dexmedetomidine can cause a reduction in stress response to laryngoscopy and intubation. The secondary objectives were to compare the hemodynamic parameters at extubation, cough response at extubation, and postoperative sore throat. Results: A total of 165 patients were analyzed. Demographically, all the groups were similar. Group R and group D were found to significantly attenuate the heart rate (HR) at intubation and extubation when compared to group C (P < 0.05). A significant reduction in mean arterial pressure (MAP) was seen (P < 0.05; group D: 90 ± 18.4 mmHg, group C: 99.5 ± 15.9 mmHg, group R: 92.4 ± 16.1 mmHg). There was a significant reduction in cough response in both groups in comparison with group C at 0 minutes (P value; group C vs group D: <.0001; group C vs group R:.01) and 5 minutes (P value; group C vs group D: <.0001; group C vs group R: <.0001). Conclusion: Preinduction topical use of ropivacaine or dexmedetomidine, through the nebulization route, effectively attenuated the pressor responses when compared to placebo. [ABSTRACT FROM AUTHOR]

Background and Aim: While administering general anesthesia requiring endotracheal intubation, it is a common practice to inflate the cuff with air. Continuous pressure exerted by cuff on mucosa may lead to postoperative complaints such as sore throat, cough, and dysphagia, which are very disturbing to the patient. Hence, we hypothesized that inflation of cuff with propofol may reduce the incidence of these complications as a result of cushioning effect as well as non-diffusion of nitrous oxide into it. Our aim was to compare the effects of inflation of endotracheal tube cuff with 0.9% saline, 4% lignocaine, and 1% propofol on the incidence of postoperative morbidity in terms of cough, sore throat, dysphonia, and dysphagia with general anesthesia using nitrous oxide. Methods: Patients scheduled for elective surgery under general anesthesia were randomly allocated into four equal groups of thirty each as per cuff inflation media: air (Group A), 0.9% saline (Group S), 4% lidocaine (Group L), and 1% propofol (Group P). The incidence of cough was noted at 15, 30 and 60 min after extubating. The occurrence and severity of postoperative sore throat (POST) was evaluated at 2, 6, and 24 h after extubating. Results: The incidence of cough was maximum in Group A and minimum in Group P (P < 0.05). The occurrence of POST was highest in Group A, followed by Group S and Group L, and least in Group P. The hemodynamic parameters were comparable with no statistical difference in all the four groups (P < 0.05). Conclusion: The intracuff 1% propofol is superior to 4% xylocaine and normal saline in the prevention of cough and sore throat postoperatively, whereas inflation of cuff with air leads to maximum incidence of these complications. [ABSTRACT FROM AUTHOR]

Background and Aims: Postoperative sore throat (POST) continues to be a common concern following endotracheal intubation. Objectives of the present study were to compare the effects of intracuff dexamethasone on the incidence and severity of POST, postoperative hoarseness of voice (POHV) and cough (POC). Material and Methods: This prospective, randomized, double blinded study was conducted in 60 patients undergoing short laparoscopic surgery lasting <2 h. Patients were randomly allocated into Group A and B. After intubation, endotracheal tube (ETT) cuffs were filled with saline in group A and with 0.1 mg/kg dexamethasone in group B. All patients received general anesthesia as per a standardized protocol. Incidence and severity of POST, POC, and POHV were assessed. Results: As compared to group A, the number of patients who had sore throat was significantly low in group B at 2, 6, 12, and 24 h (P < 0.001). Though more number of patients in group A had postop cough at all time points and postop hoarseness of voice at 2,6, and 12 h, the difference was statistically significant only at 2 h and 6 h for both. Severity as well as the incidence of POST, POC, and POHV showed a downward trend in both groups with time. In group B, no patient had POST after 12 h, POC after 6 h, and none complained of POHV in the postoperative period. Conclusion: Intracuff dexamethasone 0.1 mg/kg significantly reduces incidence and severity of POST, POC, and POHV which occur following general anesthesia with endotracheal intubation in patients undergoing short pelvic laparoscopic procedures lasting <2 h. [ABSTRACT FROM AUTHOR]

Context: Postoperative sore throat (POST) is a frequent and undesirable complication after general anesthesia with endotracheal intubation. Various pharmacological and non-pharmacological methods with variable success rate are used for attenuating POST. However, no single drug has been universally accepted. Aims: To compare the effect of betamethasone gel, ketamine gargles and intravenous dexamethasone on the incidence and severity of POST. Settings and Design: Prospective randomized controlled single-blinded trial conducted at a tertiary care centre. Materials and Methods: A total of 100 patients of age 18 to 70 yr, ASA class I and II, scheduled for elective surgeries under general anaesthesia were included and divided randomly in betamethasone, dexamethasone, ketamine and control groups. Endotracheal tubes were lubricated with 0.05% betamethasone gel in betamethasone group, 0.2 mg/kg of dexamethasone was administered intravenously before induction of anaesthesia in dexamethasone group, 40 mg of ketamine gargles mixed with 30 ml of saline was given 5 minutes prior to induction in ketamine group. In the control group, none of the above agents were used. During the 24 hr after the operation, we noted the occurrence and severity of POST, cough and hoarseness. Statistical Analysis Used: The demographic data, surgical time and intubation among the groups were analyzed using one-way analysis of variance. Incidence and severity of POST, cough and hoarseness of voice among the groups were analyzed utilizing Chi-square test. Results: Incidence of POST at one hour was found to be significantly less in betamethasone group (16%) and dexamethasone group (20%) in comparison to the control group (48%). The incidence of POST at 4 hours and 24 hours were found to be comparable. The frequency of hoarseness and cough at 1 hour, 4 hour and 24 hours were similar in all the groups. Conclusions: Prophylactic betamethasone gel application and intravenous dexamethasone administration before induction of anaesthesia resulted in clinically important and statistically significant decreases in the incidence of POST only in early postoperative period. [ABSTRACT FROM AUTHOR]

Background: Use of Baska Mask, since a supraglottic airway device, could result in low incidence of postoperative pharyngolaryngeal complications. Aims: The objectives were to compare the effect of Baska Mask versus endotracheal intubation on the incidence and severity of postoperative sore throat (POST), postoperative hoarseness of voice (POHV), and postoperative cough (POC). Settings and Design: This prospective randomized study was conducted in a tertiary care teaching institute in 120 patients undergoing short laparoscopic surgeries. Subjects and Methods: Airway was secured using with low-pressure, high-volume cuffed endotracheal tube in Group T and with Baska Mask in Group B. POST, POC, and POHV were assessed at 2, 6, 12, and 24 h after surgery. Those with Grade III score throat were managed by gargling with dispersible aspirin 75 mg. Statistical Analysis Used: Pearson's Chi-square test, Fisher's exact test, and independent sample t-test were used as applicable. Results: Group B patients required significantly more attempts at securing airway. Incidence of POST was significantly higher in Group T as compared to that Group B at 2, 6, 12, and 24 h after surgery. POC was significantly more in Group T at 2, 6, and 12 h. No patient in Group B had POC at 12 and 24 h. POHV showed significantly higher incidence in Group T at 2 and 6 h. No patient in Group B had hoarseness at 6, 12, and 24 h. Conclusion: Use of Baska Mask as compared to endotracheal intubation significantly reduces the incidence and severity of pharyngolaryngeal complications such as POST, POC, and POHV in patients undergoing short laparoscopic surgeries. [ABSTRACT FROM AUTHOR]

Background and Aims: Coughing and sore throat postoperatively are common clinical problems during general anesthesia which can be avoided by various methods including topicalization of airway with local anesthetics, endotracheal tube cuff (ETT) inflation with local anesthetics, use of intravenous drugs such as dexamethasone, maintaining ETT cuff pressure, intubation by an experienced anethesiologist, etc. The aims of the study were to compare postextubation coughing response, mean number of cuff deflations required intraoperatively, and postoperative airway morbidity in terms of sore throat (2 h and 18–24 h), hoarseness of voice, and dysphagia following inflation of ETT cuff with air, anesthetic gas mixture, saline, and 2% lignocaine during general anesthesia. Material and Methods: One hundred and four patients were randomized into 1 of 4 groups depending on whether air, anesthetic gas mixture, saline, or 2% lignocaine was used to inflate the cuff of ETT using computer-generated randomization table. Results: There was no significant difference in the postextubation cough response among the four groups. The mean number of times the ETT cuff was deflated was significantly in favor of liquid media comapred to gaseous media (P < 0.001). The incidence of sore throat at 2 h and at 18–24 h, hoarseness of voice, and dysphagia were comparable in all groups. Conclusion: ETT cuff inflation with air, anesthetic gas mixture, 2% lignocaine, and saline are comparable in terms of incidence of postextubation cough and postoperative airway morbidity symptoms such as sore throat, hoarseness of voice, and dysphagia. [ABSTRACT FROM AUTHOR]

Context: Postoperative sore throat (POST) is a very common complaint following tracheal intubation. Although it resolves spontaneously, efforts must be taken to reduce it. Aims: This study aims to compare the effect of cuff inflation using manometer versus conventional technique on the incidence of POST. Secondary objectives were to assess the incidence postoperative hoarseness and cough. Settings and Design: A total of 120 patients were included in this prospective observational comparative study. Subjects and Methods: After approval from the hospital ethics committee, consenting American Society of Anesthesiologists physical status Class I and II patients, scheduled for gynecologic laparoscopic surgery under general anesthesia, were included. They were randomly allocated by closed envelope technique to either Group A where the cuff pressure was adjusted to 25 cmH2O using a manometer or Group B where cuff inflation was guided clinically. Patients were monitored for sore throat, hoarseness of voice, and cough postoperatively. Statistical Analysis Used: To calculate the incidence of sore throat, hoarseness, and cough, descriptive statistics were applied. For checking association of sore throat and cuff pressure, Chi-square test and for comparing numerical values independent sample t-test were applied. Results: The incidence of POST was significantly less in Group A than in B (P < 0.001) up to 24 h. Incidence of hoarseness was less in Group A and incidence of cough was higher in Group B, but these differences were not statistically significant. Conclusion: Cuff inflation guided by manometer significantly reduces the incidence of POST. [ABSTRACT FROM AUTHOR]

Background: Postoperative sore throat (POST) is the most common airway-related complaint of patients after endotracheal intubation. Postextubation coughing during emergence from general anesthesia (GA) is an important problem. Objectives: To compare the effects of topical benzydamine hydrochloride and 2% lignocaine on reducing the incidence and severity of POST, hoarseness, and coughing after general endotracheal anesthesia. Materials and Methods: Patients were randomly allocated into three groups of 30 patients each. In Group B (topical benzydamine hydrochloride), Group L (2% lignocaine gel), Group N (normal saline) was applied to the cuffed endotracheal tube (ETT) before intubation. Results: The trend of the severity of sore throat, hoarseness of voice, and cough during the first 24 h after the GA in benzydamine recipients was significantly lower than the other two groups (P < 0.05). Conclusions: It was observed that the incidence of POST, hoarseness of voice, and cough was significantly less when cuff of ETT was lubricated with topical benzydamine hydrochloride as compared with 2% lignocaine gel. [ABSTRACT FROM AUTHOR]