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

Singh, Narinder Pal; Makkar, Jeetinder Kaur; Cappellani, Ron B.; Lakshminarasimhachar, Anand; Singh, Preet Mohinder

doi:10.1007/s12630-020-01792-4

Cited by 16 publications

(10 citation statements)

References 83 publications

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“…In a randomised controlled trial, dexamethasone, with or without lidocaine, was effective in reducing the incidence of POST in patients requiring prolonged tracheal intubation 4. Singh et al 5 also found that corticosteroids were among the three topical agents most closely associated with reduction of POST. In our study, the lack of dexamethasone use (OR=5.71) was shown to be a significant risk factor for POST.…”

Section: Discussionmentioning

confidence: 99%

“…Intubation lasting longer than 90 min yielded a higher likelihood (OR=1.27) of POST 4. Various non-pharmacological measures (supraglottic ventilation devices, smaller tracheal tubes, limited cuff pressure and good muscle relaxation) and pharmacological measures (lidocaine, dexamethasone and non-steroidal anti-inflammatory drugs) have been used to prevent or reduce the incidence of this complication 5…”

Section: Introductionmentioning

confidence: 99%

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Development of a nomogram for prediction of postoperative sore throat in patients under general anaesthesia: a single-centre, prospective, observational study

Jiang

Wang

et al. 2022

BMJ Open

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ObjectivesPostoperative sore throat (POST) is very common in patients under general anaesthesia. However, there is no effective clinical predictive model for reducing its occurrence. The objective of this study was to estimate the risk factors for POST in patients after general anaesthesia by designing a nomogram.DesignA prospective study.SettingThis study was conducted in a large tertiary hospital.ParticipantsPatients aged 18–85 years old who received general anaesthesia with either an endotracheal tube or supraglottic airway and of American Society of Anesthesiologists classification level Ⅰ–III.ResultsA total of 442 patients were enrolled in this study, with a POST incidence of 44.1%. The results showed that younger age (≤55 years), surgical site (head and neck surgery), duration of anaesthesia (≥4 hours) and history of chronic pharyngitis were independent risk factors for POST in general anaesthesia patients. Receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the nomogram. The area under the ROC curve was 0.784 and the C-index was 0.779.ConclusionA nomogram combining age, surgical site, duration of anaesthesia and history of chronic pharyngitis is potentially useful in predicting POST under general anaesthesia.Trial registration numberChiCTR-ROC-17013258; Post-results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of a nomogram for prediction of postoperative sore throat in patients under general anaesthesia: a single-centre, prospective, observational study

Jiang

Wang

et al. 2022

BMJ Open

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“…We chose the Bayesian inferential framework because it allows external information to be included and can capture and propagate uncertainty. In addition, it will not be biased by small sample size, while the frequentist inference often becomes biased when the sample size decreases ( 29 , 30 ). The OpenBUGS 3.2.3 (members of OpenBUGS Project Management Group, see www.openbugs.net ) and GeMTC 0.14.3 (Generate Mixed Treatment Comparisons, see http://drugis.org/software/addis1/gemtc ) were used for the analysis of time-to-event data (PFS and OS) and the analysis of binary variables (ORR and grade ≥3 AEs), respectively.…”

Section: Methodsmentioning

confidence: 99%

Efficacy and Safety of Pyrotinib Versus T-DM1 in HER2+ Metastatic Breast Cancer Patients Pre-Treated With Trastuzumab and a Taxane: A Bayesian Network Meta-Analysis

et al. 2021

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PurposeTo compare the efficacy and safety between pyrotinib (Pyr) and trastuzumab emtansine (T-DM1) in pre-treated human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (MBC) patients.MethodsA comprehensive literature search of the PubMed, EMBASE, and Web of Science was performed in August 2020. Randomized clinical trials comparing the efficacy and safety between different anti-HER2 regimens in patients pre-treated with trastuzumab (Tra) and a taxane in metastatic settings (≤second-line treatment) were included. A fixed effects network meta-analysis based on the Bayesian inferential framework was conducted for progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and grade ≥3 adverse events (AEs). Values of surface under cumulative ranking probability curve (SUCRA) were calculated to offer a ranking of all regimens.ResultsTwelve studies with 4,353 subjects were identified. Nine regimens were included into the network: T-DM1, lapatinib-capecitabine (Lap-Cap), Tra-Cap, Cap, neratinib (Ner), pertuzumab (Per)-Tra-Cap, Pyr-Cap, atezolizumab (Ate)-T-DM1, and Ner-Cap. For PFS, Pyr-Cap was more favorable than T-DM1 (hazard ratio, 95% confidence interval: 0.77, 0.70–0.86), Lap-Cap (0.64, 0.59–0.69), Tra-Cap (0.63, 0.56–0.70), Cap (0.50, 0.45–0.56), Ner (0.59, 0.51–0.69), Per-Tra-Cap (0.68, 0.59–0.79), and Ner-Cap (0.72, 0.64–0.81). For OS, Pyr-Cap showed further improvement than Lap-Cap (hazard ratio, 95% confidence interval: 0.71, 0.52–0.99), Cap (0.68, 0.49–0.96), and Ner (0.65, 0.45–0.94). For ORR, Pyr-Cap was significantly superior than Cap (odds ratio, 95% confidence interval: 7.87, 1.22–56.51). No significant difference was observed in grade ≥3 AEs among all the regimens. Pyr-Cap ranked in the highest in PFS, OS, ORR, and grade ≥3 AEs (SUCRA = 99.4, 89.7, 86.4, and 89.3%).ConclusionsThese results indicate that Pyr may be more effective than T-DM1 in HER2+ MBC patients pre-treated with Tra and a taxane. However, it may be associated with more grade ≥3 AEs.

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“…35 Singh et al conducted a meta-analysis of 42 trials comparing eight treatment regimens and found that inhaled corticosteroid therapy was the probably the best treatment regimen to reduce the early development of sore throat (4-6 hours from extubation). 36…”

Section: Steroid Therapymentioning

confidence: 99%

Management of post-operative sore throat in patients undergoing endotracheal intubation: literature review

Sharkawy¹,

Rawas

Altoies

et al. 2021

Int J Community Med Public Health

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Postoperative sore throat (POST) is a common complaint that is classified as the 8th most undesirable events after general anesthesia. Endotracheal intubation has been estimated to be the commonest factor causing POST. We aim to review the risk factors and preventive measures to reduce the incidence and severity of POST following endotracheal intubation. Although sore throat can be induced by many perioperative factors, endotracheal intubation remains the commonest cause that can induce endothelial injury and a subsequent sore throat. Many risk factors for this association has been reported. The most common risk factors include ages less than 60 years of age, female sex, cough, and asthma, underlying chest diseases, type and timing of the operation, type, and size of the used endotracheal tube. Moreover, the experience of the personnel intubating the patients may have been another risk factor. Medical prevention of POST can be achieved by several agents as steroids, non-steroidal anti-inflammatory drugs (NSAIDS), N-methyl-D-aspartate (NMDA) receptor antagonists, careful monitoring of the tracheal cuff pressure, and licorice application. On the other hand, using lidocaine has been contraindicated according to previous meta-analysis results. Additionally, we recommend that future studies with bigger sample sizes are should be conducted for further validation of the new modalities.

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

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.

Cited by 16 publications

References 83 publications

Development of a nomogram for prediction of postoperative sore throat in patients under general anaesthesia: a single-centre, prospective, observational study

Development of a nomogram for prediction of postoperative sore throat in patients under general anaesthesia: a single-centre, prospective, observational study

Efficacy and Safety of Pyrotinib Versus T-DM1 in HER2+ Metastatic Breast Cancer Patients Pre-Treated With Trastuzumab and a Taxane: A Bayesian Network Meta-Analysis

Management of post-operative sore throat in patients undergoing endotracheal intubation: literature review

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