Comparative Evaluation of Preoperative Paracetamol and a Combination of Paracetamol with Nebulized or Intravenous Dexamethasone for Prevention of Postoperative Sore Throat.

Background and Aims: Postoperative sore throat (POST) is a common complication following general anesthesia with tracheal intubation that increases patient morbidity. We evaluated the effect of preoperative administration of IV paracetamol and a combination of paracetamol with nebulized or IV dexamethasone on the incidence of POST (primary objective), hoarseness of voice and cough (secondary objectives) in adult patients. Methods: In a randomized, double‑blind study in a tertiary care hospital, 150 patients undergoing laparoscopic cholecystectomy under general anesthesia with tracheal intubation were divided into three groups (n = 50): Group P received IV paracetamol 1 g infusion; Group I received IV dexamethasone 8 mg and IV paracetamol 1 g infusion; and Group N received nebulized dexamethasone 8 mg and IV Paracetamol 1 g infusion. The incidence and severity of POST, hoarseness and cough were assessed at various time‑points for 24 hours after surgery. Results: The overall incidence of POST was 72%, 18%, and 24% in groups P, I, and N, respectively; P < .0001. The severity of POST was significantly less in groups I and N compared with group P; both P < .0001. The incidence of postoperative hoarseness was comparable between the three groups; P = 0.216. The incidence and severity of postoperative cough were significantly higher in group P compared with group I; P = 0.016. Statistical calculations were done using SPSS 21 version program for Windows. Conclusions: Prophylactic administration of both nebulized and IV dexamethasone 8 mg in combination with IV paracetamol was effective in decreasing the incidence and severity of POST in adult patients undergoing laparoscopic cholecystectomy under general anesthesia with tracheal intubation. [ABSTRACT FROM AUTHOR]