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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 11/2020

01-11-2020 | Cough | Review Article/Brief Review

Efficacy of topical agents for prevention of postoperative sore throat after single lumen tracheal intubation: a Bayesian network meta-analysis

Authors: Narinder P. Singh, MD, Jeetinder K. Makkar, MD, Ron B. Cappellani, FRCPC, Ashish Sinha, MD, Anand Lakshminarasimhachar, MD, Preet Mohinder Singh, MD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 11/2020

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Abstract

Background

The optimal choice of prophylactic drugs to decrease postoperative sore throat is unclear. The objective of this network meta-analysis (NMA) was to compare and rank 11 topical agents used to prevent postoperative sore throat.

Methods

Various databases were searched independently for randomized-controlled trials (RCTs) comparing topical agents used for the prevention of postoperative sore throat. Inclusion criteria were parallel group studies comparing intervention with active or inactive control and reporting postoperative sore throat. The primary outcome was postoperative sore throat at 24 hr. Secondary outcomes were early sore throat at 4–6 hr, cough, and hoarseness at 24 hr.

Results

Evidence was synthesized from 70 RCTs reporting 7,141 patients. Topical application of lidocaine, corticosteroids, ketamine, magnesium, benzydamine, water-based lubricant, and liquorice applied along the tracheal tube, to the tracheal tube cuff, gargled or sprayed were compared with intracuff air and each other. Bayesian NMA showed that magnesium (odds ratio [OR], 0.10; 95% credible interval [CrI], 0.03 to 0.26), liquorice (OR, 0.14; 95% CrI, 0.03 to 0.55), and steroid application (OR, 0.11; 95% CrI, 0.06 to 0.22) most effectively prevented postoperative sore throat at 24 hr. Topical lidocaine was the least effective intervention.

Conclusion

Topical application of magnesium followed by liquorice and corticosteroids most effectively prevented postoperative sore throat 24 hr after endotracheal intubation.
Appendix
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Metadata
Title
Efficacy of topical agents for prevention of postoperative sore throat after single lumen tracheal intubation: a Bayesian network meta-analysis
Authors
Narinder P. Singh, MD
Jeetinder K. Makkar, MD
Ron B. Cappellani, FRCPC
Ashish Sinha, MD
Anand Lakshminarasimhachar, MD
Preet Mohinder Singh, MD
Publication date
01-11-2020
Publisher
Springer International Publishing
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 11/2020
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-020-01792-4

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