International Journal of Research in Medical Sciences | May 2019 | Vol 7 | Issue 5 Page 1665
International Journal of Research in Medical Sciences
Sugathan R et al. Int J Res Med Sci. 2019 May;7(5):1665-1669
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Efficacy of intracuff dexamethasone in reducing the incidence of post-
operative sore throat: an original article
Reshma Sugathan
1
, Sumesh Raj
2
*
INTRODUCTION
Postoperative sore throat is the most common and most
distressing complaint of patients after general anaesthesia
with cuffed endotracheal tube. About 80% of patients
complain of sore throat after anaesthesia and surgery.
Common causes include trauma to tonsillar pillars,
pharynx and larynx, tracheal mucosal and ciliary damage
and ulcerations from excessive cuff pressure.
1
Postoperative sore throat can be prevented by the use of
low intracuff pressure, smaller- sized and steroid coated
endotracheal tubes, use of inhalational steroids and
topical lidocaine.
2
Dexamethasone is a potent synthetic glucocorticoid
having anti-inflammatory and immunosuppressant
1
Department of Anaesthesia,
2
Department of Internal Medicine, Sree Gokulam Medical College and Research
Foundation, Trivandrum, Kerala, India
Received: 04 December 2018
Accepted: 06 January 2019
*Correspondence:
Dr. Sumesh Raj,
E-mail: drsumeshraj@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Postoperative sore throat is the most common and most distressing complaint of patients after general
anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff
dexamethasone in reducing the incidence of this distressing postoperative symptom.
Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal
saline respectively. The cuff was prefilled with dexamethasone or normal saline one hour prior to intubation to allow
time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients
were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore
throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post
operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs
after surgery.
Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients
(8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically
significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of
hoarseness of voice between the two groups.
Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to
intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence
of hoarseness of voice.
Keywords: Cough, Dexamethasone, Intracuff, Normal saline, Postoperative, Sore throat
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191655