The Prophylactic Effects of Dexamethasone on Postoperative Sore Throat and Hoarseness after Double Lumen Endobronchial Tube Intubation: a Randomized Controlled Trial
Keywords:
Dexamethasone, Postoperative sore throat, Hoarseness, Double-lumen tube, Thoracic surgeryAbstract
Postoperative sore throat (POST) and hoarseness are common complications following double-lumen endobronchial tube (DLT) intubation. This randomized, double-blinded, controlled trial aimed to evaluate the efficacy and safety of prophylactic dexamethasone in 94 patients undergoing thoracic surgery requiring DLT intubation at Sakon Nakhon Hospital between November 2022 and May 2023. Patients were randomly allocated to receive either dexamethasone 0.2 mg/kg or normal saline intravenously after anesthesia induction. Primary outcomes were the incidence and severity of POST and hoarseness at 1 and 24 hours postoperatively. Secondary outcomes included adverse effects.
The dexamethasone group showed significantly lower incidence of POST at both 1 hour (2.17% vs 28.26%, p < 0.001) and 24 hours (15.22% vs 56.52%, p < 0.001) postoperatively. The relative risk reduction at 24 hours was 73.07%, with a number needed to treat of 2.42. Hoarseness was also significantly reduced at 24 hours (6.52% vs 30.43%, p = 0.003). No significant adverse effects were observed during the 2-week follow-up period. Given these findings and its favorable risk-benefit profile, prophylactic intravenous dexamethasone 0.2 mg/kg is recommended for routine use in eligible patients undergoing thoracic surgery with DLT intubation.
References
Eastwood J, Mahajan R. One‐lung anaesthesia. BJA CEPD Reviews 2002;2(3):83-7.
Morgan G, Mikhail M, Murray M, Larson C. Anesthesia for thoracic surgery. Clinical Anesthesiology 3th ed New York: McGraw-Hill Companies; 2002. p. 525-51.
Knoll H, Ziegeler S, Schreiber J-U, Buchinger H, Bialas P, Semyonov K, et al. Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker: a randomized, prospective, controlled trial. The Journal of the American Society of Anesthesiologists 2006;105(3):471-7.
El-Boghdadly K, Bailey C, Wiles M. Postoperative sore throat: a systematic review. Anaesthesia 2016;71(6):706-17.
McHardy F, Chung F. Postoperative sore throat: cause, prevention and treatment. Anaesthesia 1999;54(5):444-53.
Jones M, Catling S, Evans E, Green D, Green J. Hoarseness after tracheal intubation. Anaesthesia 1992;47(3):213-6.
Christensen A, Willemoes-Larsen H, Lundby L, Jakobsen K. Postoperative throat complaints after tracheal intubation. British Journal of Anaesthesia 1994;73(6):786-7.
Lee KH, Lim HK, Lee KM, Kim SY. The Incidence of Sore Throat and Hoarseness after Double-Lumen Endobronchial Tube Intubation. Korean Journal of Anesthesiology 1998;35(3):484-7.
Higgins P, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. British journal of anaesthesia 2002;88(4):582-4.
Vyvey M. Steroids as pain relief adjuvants. Canadian Family Physician 2010;56(12):1295-7.
De Oliveira GS, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. The Journal of the American Society of Anesthesiologists 2011;115(3):575-88.
Waldron N, Jones C, Gan T, Allen T, Habib A. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. British journal of anaesthesia 2013;110(2):191-200.
Bagchi D, Mandal MC, Das S, Sahoo T, Basu SR, Sarkar S. Efficacy of intravenous dexamethasone to reduce incidence of postoperative sore throat: A prospective randomized controlled trial. Journal of Anaesthesiology Clinical Pharmacology 2012;28(4):477-80.
Park SH, Han SH, Do SH, Kim JW, Rhee Ky, Kim JH. Prophylactic dexamethasone decreases the incidence of sore throat and hoarseness after tracheal extubation with a double-lumen endobronchial tube. Anesthesia & Analgesia 2008;107(6):1814-8.
Kuriyama A, Maeda H. Preoperative intravenous dexamethasone prevents tracheal intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis. Canadian Journal of Anesthesia 2019;66(5):562-75.
Tien M, Gan T, Dhakal I, White W, Olufolabi A, Fink R, et al. The effect of anti‐emetic doses of dexamethasone on postoperative blood glucose levels in non‐diabetic and diabetic patients: a prospective randomised controlled study. Anaesthesia 2016;71(9):1037-43.
Downloads
Published
How to Cite
Issue
Section
License
บทความที่ตีพิมพ์ถือว่าเป็นลิขสิทธิ์ของวารสารโรงพยาบาลสกลนคร การคัดลอกเพื่อพัฒนาเชิงวิชาการต้องได้รับการอ้างอิงอย่างถูกต้อง
