Skip to main content
Top
Published in: BMC Anesthesiology 1/2024

Open Access 01-12-2024 | Sore Throat | Research

Role of preoperative zinc, magnesium and budesonide gargles in Postoperative Sore Throat (POST) - a randomised control trial

Authors: Aakanksha Bhanwra, Sanjeev Palta, Richa Saroa, Puja Saxena, Sangeeta Bhanwra, Aditi Jain

Published in: BMC Anesthesiology | Issue 1/2024

Login to get access

Abstract

Background

Post-operative sore throat (POST) has an incidence ranging from 21 to 80%. To prevent the development of POST, several pharmacological measures have been tried. Aim of this study was to compare the efficacy of preoperative zinc, magnesium and budesonide gargles in reducing the incidence and severity of POST in patients who underwent endotracheal intubation for elective surgeries.

Methods

We conducted a prospective, randomized, double-blind, controlled equivalence trial in 180 patients admitted for elective surgical procedures under general anaesthesia. Patients were randomised into three groups; group Z received 40 mg Zinc, group M received 250 mg Magnesium Sulphate and group B received 200 µg Budesonide in the form of 30 ml tasteless and colourless gargle solutions. Sore throat assessment and haemodynamic recording was done postoperatively at immediate recovery (0 h) and 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0–3).

Results

POST score was comparable at all recorded time points i.e. 0,2,4,6,8,12 and 24 h. Maximum incidence was seen at 8 h in group B (33.3%) and the minimum incidence was at 24 h in group Z (10%) (p > 0.05). It was found that the incidence of POST was more in the surgeries lasting longer than 2 h in all groups. This difference was found to be statistically significant in Groups M and B. The incidence of POST was found to be comparable between laparoscopic and open procedures.

Conclusion

Magnesium, zinc and budesonide have an equivocal effect in the prevention of POST at different time points. The incidence of sore throat increases significantly in surgeries lasting more than two hours if magnesium or budesonide have been used as premedicant. Duration of surgery is an independent predictor for POST.

Trial registration

CTRI/2021/05/033741 Date-24/05/2021(Clinical Trial Registry of India).
Literature
1.
go back to reference Walker EMK, Bell M, Cook TM, Grocott MPW, Moonesinghe SR. Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study. Br J Anaesth. 2016;117(6):758–66.CrossRefPubMed Walker EMK, Bell M, Cook TM, Grocott MPW, Moonesinghe SR. Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study. Br J Anaesth. 2016;117(6):758–66.CrossRefPubMed
2.
go back to reference Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582–4.CrossRefPubMed Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582–4.CrossRefPubMed
3.
go back to reference Rajan S, Tosh P, Paul J, Kumar L. Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough. Indian J Anaesth. 2018;62(1):66–71.CrossRefPubMedPubMedCentral Rajan S, Tosh P, Paul J, Kumar L. Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough. Indian J Anaesth. 2018;62(1):66–71.CrossRefPubMedPubMedCentral
4.
go back to reference Ratnaraj J, Todorov A, McHugh T, Cheng MA, Lauryssen C. Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery. J Neurosurg. 2002;97:176–9.PubMed Ratnaraj J, Todorov A, McHugh T, Cheng MA, Lauryssen C. Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery. J Neurosurg. 2002;97:176–9.PubMed
5.
go back to reference Sumathi PA, Shenoy T, Ambareesha M, Krishna HM. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Anaesth. 2008;100(2):215–8.CrossRefPubMed Sumathi PA, Shenoy T, Ambareesha M, Krishna HM. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Anaesth. 2008;100(2):215–8.CrossRefPubMed
6.
go back to reference Singh NP, Makkar JK, Wourms V, Zorrilla-Vaca A, Cappellani RB, Singh PM. Role of topical magnesium in post-operative sore throat: a systematic review and meta-analysis of randomised controlled trials. Indian J Anaesth. 2019;63(7):520–9.CrossRefPubMedPubMedCentral Singh NP, Makkar JK, Wourms V, Zorrilla-Vaca A, Cappellani RB, Singh PM. Role of topical magnesium in post-operative sore throat: a systematic review and meta-analysis of randomised controlled trials. Indian J Anaesth. 2019;63(7):520–9.CrossRefPubMedPubMedCentral
7.
go back to reference Agarwal A, Nath SS, Goswami D, Gupta D, Dhiraaj S, Singh PK. An evaluation of the efficacy of aspirin and benzydamine hydrochloride gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study. Anesth Analg. 2006;103(4):1001–3.CrossRefPubMed Agarwal A, Nath SS, Goswami D, Gupta D, Dhiraaj S, Singh PK. An evaluation of the efficacy of aspirin and benzydamine hydrochloride gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study. Anesth Analg. 2006;103(4):1001–3.CrossRefPubMed
8.
9.
go back to reference Farhang B, Grondin L. The Effect of Zinc Lozenge on Postoperative Sore Throat: a prospective Randomized, Double-Blinded, placebo-controlled study. Anesth Analg. 2018;126(1):78–83.CrossRefPubMed Farhang B, Grondin L. The Effect of Zinc Lozenge on Postoperative Sore Throat: a prospective Randomized, Double-Blinded, placebo-controlled study. Anesth Analg. 2018;126(1):78–83.CrossRefPubMed
10.
go back to reference Jung TH, Rho JH, Hwang JH, Jong-Hyuk L, Seung-Cheol C, Seong W. The effect of the humidifier on sore throat and cough after thyroidectomy. Korean J Anesthesiol. 2011;61(6):470–4.CrossRefPubMedPubMedCentral Jung TH, Rho JH, Hwang JH, Jong-Hyuk L, Seung-Cheol C, Seong W. The effect of the humidifier on sore throat and cough after thyroidectomy. Korean J Anesthesiol. 2011;61(6):470–4.CrossRefPubMedPubMedCentral
11.
go back to reference El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: a systematic review. Anaesthesia. 2016;71(6):706–17.CrossRefPubMed El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: a systematic review. Anaesthesia. 2016;71(6):706–17.CrossRefPubMed
12.
go back to reference Arbabi-kalati F, Arbabi-kalati F, Deghatipour M, Moghadam AR. Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapy-induced mucositis: a double-blind randomized clinical trial. Arch Iran Med. 2012;15(7):413–7.PubMed Arbabi-kalati F, Arbabi-kalati F, Deghatipour M, Moghadam AR. Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapy-induced mucositis: a double-blind randomized clinical trial. Arch Iran Med. 2012;15(7):413–7.PubMed
13.
go back to reference Truong-Tran AQ, Carter J, Ruffin R, Zalewski PD. New insights into the role of zinc in the respiratory epithelium. Immunol Cell Biol. 2001;79(2):170–7.CrossRefPubMed Truong-Tran AQ, Carter J, Ruffin R, Zalewski PD. New insights into the role of zinc in the respiratory epithelium. Immunol Cell Biol. 2001;79(2):170–7.CrossRefPubMed
14.
go back to reference Chen YQ, Li JP, Xiao J. Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints. Eur Arch Otorhinolaryngol. 2014;271(6):1667–72.CrossRefPubMed Chen YQ, Li JP, Xiao J. Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints. Eur Arch Otorhinolaryngol. 2014;271(6):1667–72.CrossRefPubMed
17.
go back to reference Kotb M, Fouad H, Sabry A, Othman Y. Effectiveness of inhaled magnesium sulphate versus inhaled budesonide in reducing post-operative sore throat in smokers after endo-tracheal intubation. Surg Curr Res. 2015;5(7):105. Kotb M, Fouad H, Sabry A, Othman Y. Effectiveness of inhaled magnesium sulphate versus inhaled budesonide in reducing post-operative sore throat in smokers after endo-tracheal intubation. Surg Curr Res. 2015;5(7):105.
19.
go back to reference Borazan H, Kececioglu A, Okesli S, Otelcioglu S. Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study. Anesthesiology. 2012;117(3):512–8.CrossRefPubMed Borazan H, Kececioglu A, Okesli S, Otelcioglu S. Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study. Anesthesiology. 2012;117(3):512–8.CrossRefPubMed
20.
go back to reference Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad. 2007;19(2):12–4.PubMed Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad. 2007;19(2):12–4.PubMed
Metadata
Title
Role of preoperative zinc, magnesium and budesonide gargles in Postoperative Sore Throat (POST) - a randomised control trial
Authors
Aakanksha Bhanwra
Sanjeev Palta
Richa Saroa
Puja Saxena
Sangeeta Bhanwra
Aditi Jain
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2024
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-024-02534-5

Other articles of this Issue 1/2024

BMC Anesthesiology 1/2024 Go to the issue