Global incidence and risk factors of post-operative sore throat among patients who underwent surgery: A systematic review and meta-analysis

Abstract

Background Postoperative sore throat is a common, uncomfortable, stressful sequel of tracheal intubation that contributes to postoperative mortality and morbidity following general anesthesia. Therefore, reducing risks of post-operative sore throat is important to improve patient outcome. Objectives The objective of this systematic review and meta-analysis was to evaluate the incidence and risk factors of postoperative sore throat among patients who underwent surgery. Methods Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, Hinari and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. Funnel plot was used for visual assessment of publication bias. Subgroup analyses by country and meta-regression was performed to explore the possible causes of heterogeneity. Egger’s weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. Stata v14.0 (Statacorp, College Station, Texas, USA) software was used for all statistical analyses. STATA software version 14 was used for all statistical analyses. Result A total of 11 studies with 5885 total sample size were included. The total number of patients who developed Post-operative sore throat was 2252. The pooled prevalence of Post-operative sore throat was 40.48% (95% CI: 35.16, 45.79). The visual inspection of the funnel plot showed the symmetrical distribution. Patients who had number of a single attempts were about 42.5% less likely to develop POST than patients who had multiple intubation attempts (OR: 0.58(0.38–0.88), P = 010, I2: 86.6%. Additionally, duration of tube in place less than 1 h was about 18.7% more likely to develop POST than who were not (OR: 1.19(0.29–4.79), P = 0.028, I2: 0.0%). The other independent predictors of POST were OR: 3.01(0.57–15.84), P = 0.19, I2: 92.3%) and OR: 1.56(0.97–2.58), P = 0.080, I2: 0.0%) respectively. Conclusions Patients’ age and sex, size of ETT and LMA, duration of ETT in trachea, experience of anesthetists’, number of attempts, induction agent, and smoking were revealed more common causes of sore throat. The number of attempts and the length of tube in place were both linked to the occurrence of postoperative sore throat. Research Registry Our unique identifying number is reviewregistry1416. Highlights

Incidence of Post-Op Sore Throat in Tertiary Care Hospital of Khyber Pukhtankhwa

“…Furthermore, POST has been found to have an association with duration of intubation and type of surgery as mentioned in a systemic review by Obsa MS et.al [32]. Even the use of nasogastric tube has been associated with this complication [33]. Surprisingly though, the following study did not show any significant association of post operative sore throat with the study variables as Pearson chi square gave us p-values greater than 0.05.…”

“…A Hospital based cross sectional study by Efrem Fenta and his co-authors declared female gender, larger sized endotracheal tubes and multiple attempts at intubation as elements to cause POST [31]. Furthermore, POST has been found to have an association with duration of intubation and type of surgery as mentioned in a systemic review by Obsa MS et.al [32]. Even the use of nasogastric tube has been associated with this complication [33].…”

Perbandingan Tingkat Kenyamanan Pasca Pembiusan Umum dengan LMA Classic dan LMA Proseal di RSUD Arifin Achmad Provinsi Riau

“…Cedera pada epitel, seperti saat laringoskopi dan intubasi, dapat menyebabkan kerusakan tambahan pada mukosa yang kering, yang mengakibatkan POST. 21…”

Comparing the Effect of Zinc-impregnated Pharyngeal Packs with Conventional Methods on the Level of Sore Throat Among Patients Undergoing Septorhinoplasty

“…Postoperative sore throat (POST) syndrome is commonly observed after tracheal intubation, with an incidence rate of 14.5 -50% (1)(2)(3)(4)(5). Its incidence after tracheal intubation varies from 6.6 to 90% (6). POST is the second most prevalent complaint following anesthesia, i.e., secondary to nausea/vomiting (4,5).…”

“…way suctioning, prolonged intubation, wearing laryngeal masks, damaged airway mucosa during laryngoscopy and using an oral airway and large endotracheal tubes (2,3,(6)(7)(8)(9). Although the etiology of POST has not yet been fully understood, the inflammatory process appears to play an effective role (3).…”