Postoperative sore throat prevention in ambulatory surgery: A comparison between preoperative aspirin and magnesium sulfate gargle – a prospective, randomized, double-blind study

Chattopadhyay, Surajit; Das, Anjan; Nandy, Sabyasachi; RoyBasunia, Sandip; Mitra, Tapobrata; Halder, Partha Sarathi; Chhaule, Subinay; Mandal, Shramana

doi:10.4103/0259-1162.186602

Cited by 11 publications

(12 citation statements)

References 30 publications

(48 reference statements)

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“…Borazan et al [ 55 ] performed a randomized trial of an oral magnesium lozenge and reported that preoperative administration of a single dose of oral magnesium could reduce the incidence and attenuate the severity of POST. It was recently reported that a gargle containing magnesium sulfate effectively alleviated POST [ 56 , 57 ]. In addition, when magnesium is preoperatively applied via nebulizer, the incidence and severity of POST decreased [ 58 , 59 ].…”

Section: Magnesium and Perioperative Painmentioning

confidence: 99%

Magnesium and Pain

Shin

Hwan

2020

Nutrients

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In terms of antinociceptive action, the main mode of action of magnesium involves its antagonist action at the N-methyl-d-aspartate (NMDA) receptor, which prevents central sensitization and attenuates preexisting pain hypersensitivity. Given the pivotal function of NMDA receptors in pain transduction, magnesium has been investigated in a variety of pain conditions. The oral and parenteral administration of magnesium via the intravenous, intrathecal, or epidural route may alleviate pain and perioperative anesthetic and analgesic requirements. These beneficial effects of magnesium therapy have also been reported in patients with neuropathic pain, such as malignancy-related neurologic symptoms, diabetic neuropathy, postherpetic neuralgia, and chemotherapy-induced peripheral neuropathy. In addition, magnesium treatment is reportedly able to alleviate fibromyalgia, dysmenorrhea, headaches, and acute migraine attacks. Although magnesium plays an evolving role in pain management, better understanding of the mechanism underlying its antinociceptive action and additional clinical studies is required to clarify its role as an adjuvant analgesic.

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Section: Magnesium and Perioperative Painmentioning

confidence: 99%

Magnesium and Pain

Shin

Hwan

2020

Nutrients

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“…Only one trial[16] included participants undergoing emergency surgery (i.e., acute appendicitis) and the rest of the trials enrolled elective surgeries, such as spine, abdominal and orthopaedic procedures. [13141516171819] Magnesium was given through topical routes, namely, nebulisation in four trials,[13151819] gargles in two studies[1416] and lozenges[17] was used in one trial. Nebulisation dose of magnesium ranged from 225 to 250 mg; 20 mg/kg was given through gargling across the trials and 100-mg lozenges were used.…”

Section: Resultsmentioning

confidence: 99%

“…The comparator agent with known analgesic was ketamine in three trials[131619] and aspirin in one trial. [14] Information on characteristics of patient, anaesthetic techniques, surgical procedures and number of interventions are listed in Table 1. Trial by Rajan et al .…”

Section: Resultsmentioning

confidence: 99%

“…[11] Prophylactic efficacy of magnesium has been assessed by various randomised controlled trials showing controversial results. [1213141516171819] To our knowledge, however, no systematic review has summarised the magnitude of their prophylactic efficacy from the numerous randomised trials published. Our group conducted this systematic review and meta-analysis of prospective randomised trials to study the efficacy of topical magnesium in preventing POST in adult patients undergoing surgery under general anaesthesia with single lumen tracheal tube.…”

Section: Introductionmentioning

confidence: 99%

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Role of topical magnesium in post-operative sore throat: A systematic review and meta-analysis of randomised controlled trials

et al. 2019

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Background and Aims: Post-operative sore throat (POST) is a common undesirable consequence of tracheal intubation. Magnesium, an N-methyl-D-aspartate receptor antagonist, has anti-nociceptive and anti-inflammatory properties, and has been found to be useful in POST prevention in various trials. We conducted this systematic review and meta-analysis to study the efficacy of topical magnesium in preventing POST in adult patients undergoing surgery under general anaesthesia with single lumen tracheal tube. Methods: Comprehensive literature search was performed in PubMed, Google Scholar, EMBASE, Scopus and the Cochrane central registers of controlled trial databases through July, 2018 and data were pooled using fixed effect modelling followed by random-effect methods (after assessing heterogeneity with fixed modelling). The primary outcome was the incidence of POST at 24 h after surgery/extubation. Comparative results were deliberated as pooled mean difference for continuous variables and Mantel–Haenszel (MH) odds ratio for dichotomous variables. Statistical analysis was done using Comprehensive Meta-Analysis-Version 3 (Biostat Inc., USA). Results: Seven trials involving 726 study participants were included in the final analysis. Incidence of POST at 24 hours was significantly lower in magnesium group (26/363) in comparison to active and non-active control group (89/363); P = 0.00- RR 0.22 (95%CI = 0.12-0.39, I 2 = 0%). No significant adverse events were reported with the use of topical magnesium. Conclusion: Prophylactic use of topical magnesium before the induction of general anaesthesia seems to be an effective measure to decrease the incidence of POST.

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“…Topical benzydamine hydrochloride. [ 10 ] intracuff[ 11 ] and topical lidocaine,[ 12 ] magnesium sulfate gargle,[ 13 14 ] nebulisations of ketamine and magnesium sulfate[ 15 ] are few examples.…”

Section: Discussionmentioning

confidence: 99%

Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough

et al. 2018

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Background and Aims:Post-operative sore throat (POST) is often considered an inevitable consequence of tracheal intubation. This study was performed to compare the effect of inhaled budesonide suspension, administered using a metered dose inhaler, on the incidence and severity of POST.Methods:In this prospective randomised study, 46 patients undergoing laparoscopic surgeries lasting <2 h were randomly allotted into two equal groups. Group A received 200 μg budesonide inhalation suspension, using a metered dose inhaler, 10 min before intubation, and repeated 6 h after extubation. No such intervention was performed in Group B. The primary outcome was the incidence and severity of POST. Secondary outocomes included the incidence of post-operative hoarseness and cough. Pearson's Chi-square test, Fisher's exact test and Independent sample t-test were used as applicable.Results:Compared to Group B, significantly fewer patients had POST in Group A at 2, 6, 12 and 24 h (P < 0.001). Although more patients in Group B had post-operative hoarseness of voice and cough at all-time points, the difference was statistically significant only at 12 h and 24 h for post-operative hoarseness and at 2 h and 12 h for post-operative cough. Severity as well as the incidence of POST showed downward trends in both groups over time, and by 24 h no patient in Group A had sore throat.Conclusion:Inhaled budesonide suspension is effective in significantly reducing the incidence and severity of POST.

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Postoperative sore throat prevention in ambulatory surgery: A comparison between preoperative aspirin and magnesium sulfate gargle – a prospective, randomized, double-blind study

Cited by 11 publications

References 30 publications

Magnesium and Pain

Magnesium and Pain

Role of topical magnesium in post-operative sore throat: A systematic review and meta-analysis of randomised controlled trials

Effect of inhaled budesonide suspension, administered using a metered dose inhaler, on post-operative sore throat, hoarseness of voice and cough

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