Preoperative Nebulization of Ketamine and Dexmedetomidine for Reduction in Postoperative Sore Throat: A Comparative Double-Blind Study

Amlan  Mohanty; Sarita  Swami; Kalyani Nilesh  Patil

doi:10.18502/aacc.v11i4.19354

Amlan Mohanty Department of Anesthesiology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Pune, Maharashtra, India.
Sarita Swami Department of Anesthesiology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
Kalyani Nilesh Patil Department of Anesthesiology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.

DOI: https://doi.org/10.18502/aacc.v11i4.19354

Keywords: Dexmedetomidine; General anesthesia; Ketamine; Nebulization; Sore throat

Abstract

Background: One of the most prevalent procedures involving general anesthesia (GA) is endotracheal intubation, which can lead to a variety of airway complications. Patients undergoing GA with tracheal intubation may experience a common complication, known as postoperative sore throat (POST). We conducted this study to assess and compare the effectiveness of preoperatively administered nebulized ketamine and dexmedetomidine in alleviating POST.

Methods: We randomly divided the patients into two groups, each containing 151 patients. Group-K patients were nebulized with 50 mg (1 ml) with 3 ml normal saline, while Group-D patients were nebulized with dexmedetomidine 50 mcg (0.5 ml) with 3.5 ml normal saline, preoperatively. GA was administered 15 min post-nebulization. POST was graded at 4, 6, 12, and 24 h after extubation on a four-point scale (0-3). The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 17.0.

Results: In the present study, the overall incidence of POST was 32.5%. among which 39 patients (25.8%) in the ketamine group and 59 patients (39.1%) in the dexmedetomidine group experienced POST at 4h, following extubation (P value=0.014). A significantly higher incidence of POST in the dexmedetomidine group was noticed as compared to the ketamine group (P value < 0.05). But, at 6h, 12h, and 24h, the difference was not statistically significant between the two groups. A significantly larger percentage of cases in the dexmedetomidine group had more severe POST than in the ketamine group, at 4h following extubation (p-value <0.05). There was no significant rise in systolic and diastolic blood pressure in either group. However, the ketamine group had a significantly higher mean heart rate after extubation compared to the dexmedetomidine group.

Conclusion: Ketamine nebulization significantly decreases the incidence and severity of postoperative sore throat during the early postoperative period with minimum hemodynamic changes.