Estudo comparativo entre cloridrato de benzidamina em gel, lidocaína a 5% em gel e lidocaína a 10% em spray no balonete do tubo endotraqueal em relação à dor de garganta pós‐operatória

Abstract

Postoperative sore throat is a common complication after endotracheal intubation. After tracheal intubation, the incidence of sore throat varies from 14.4% to 50%. The aim of the study was to compare between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on the endotracheal tube cuff as regards postoperative sore throat. The present study was carried out on 124 patients admitted to Alexandria university hospitals for lumbar fixation surgery requiring general anesthesia. Patients were randomly allocated into 4 groups. Benzydamine hydrochloride gel, 5% lidocaine hydrochloride gel, 10% lidocaine hydrochloride spray, or normal saline were applied on endotracheal tube cuffs before endotracheal intubation. The patients were examined for sore throat (none, mild, moderate, or severe) at 0, 1, 6, 12, and 24h after extubation. The results were collected, analyzed and presented in table and figure. The highest incidence of postoperative sore throat occurred at 6h after extubation in all groups. There was a significantly lower incidence of postoperative sore throat in the benzydamine group than 5% lidocaine gel, 10% lidocaine spray, and normal saline groups. The benzydamine group had significantly decreased severity of postoperative sore throat compared with the 10% lidocaine, 5% lidocaine, and normal saline groups at observation time point. Compared with the 5% lidocaine the 10% lidocaine group had significantly increased incidence and severity of postoperative sore throat after extubation. Compared with normal saline the 10% lidocaine group had increased incidence of postoperative sore throat. There were no significant differences among groups in local or systemic side effects. So in conclusion, benzydamine hydrochloride gel on the endotracheal tube cuff is a simple and effective method to reduce the incidence and severity of postoperative sore throat. Application of 10% lidocaine spray should be avoided because of worsening of postoperative sore throat where incidence increased but not the severity in relation to 5% lidocaine gel. Applying 5% lidocaine on the endotracheal tube cuff does not prevent postoperative sore throat but its application is better than lidocaine 10% spray or saline.

Pharmacological Interventions for Post-operative Sore Throat (POST): A Network Meta-analysis

“…Finally, we included 13 RCTs for this systematic review and meta-analysis (Fig. 1, Table 1) [7][8][9][21][22][23][24][25][26][27][28][29][30]. The inter-rater agreement between the four systematic reviewers, using the kappa statistic, was κ = 0.62.…”

The role of local inflammation in complications associated with intubation in pediatric patients: A narrative review

“…In a comparative study, it was established that the benzydamine hydrochloride gel on the ETT cuff is a simple and effective method that can significantly decrease the severity of postoperative sore throat compared with 10% lidocaine, 5% lidocaine, and normal saline 49 . However, in a subsequent study done by Yhim et al, it was concluded that application of prophylactic benzydamine hydrochloride spray to the vocal cords and upper trachea did not show a reduction in postoperative sore throat in the pediatric population 50 .…”

“…Corticosteroids Both IV and topical ETT coatings have shown to reduce airway edema and inflammation and reduce the incidence of postextubation airway stridor and sore throat. [42][43][44][45][46][47] Benzydamine hydrochloride gel Has shown variable results, with benzydamine hydrochloride gel ETT coating shown to be effective in decreasing postoperative sore throat severity, 49 but showing no reduction when applied as a spray. 50 Possible future therapies Ketamine Ketamine gargles demonstrated a significant decrease in postoperative sore throat.…”