The Effect of Flurbiprofen on Postoperative Sore Throat and Hoarseness After LMA-ProSeal Insertion: A Randomised, Clinical Trial

Uztüre, Neslihan; Menda, Ferdi; Bilgen, Semih; Keskin, Özgül; Temur, Sibel; Köner, Özge

doi:10.5152/tjar.2014.35693

Cited by 11 publications

(15 citation statements)

References 17 publications

(16 reference statements)

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“…The pre‐operative administration of a flurbiprofen lozenge reduced the severity, although not the incidence, of early postoperative sore throat . A pre‐operative 2 mg.kg −1 tramadol gargle reduced both the incidence and severity of sore throat for up to 24 h postoperatively in a small study of 50 patients , although 100 mg of intravenous hydrocortisone had no effect .…”

Section: Methodsmentioning

confidence: 95%

“…Smaller tube size [5][6][7] Use of i-gel [50,[63][64][65] SAD rather than tracheal tube [121,122] Video laryngoscopy [9,10] 90°rotational insertion technique, use of introducing stylet for ProSeal LMA laryngeal mask [81][82][83][84][85] Oral rather than nasotracheal intubation [124] Limiting cuff pressure [32][33][34] Cuff pressure limitation ≤ 60 cmH 2 O [88][89][90][91][92][93]96] Cuffed rather than uncuffed tubes [125] Intravenous, topical or inhaled steroids [22][23][24][25] Topical steroids, NSAIDs, tramadol [98,101,102] Limiting tracheal tube cuff pressure [126] Topical NSAIDs [27][28][29]31] Propofol induction and maintenance [106,107] SAD cuff pressure limitation ≤ 60 cmH 2 O [130][131][132][133] Liquorice, magnesium and ketami...…”

Section: Tracheal Intubation Sads Childrenmentioning

confidence: 99%

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Postoperative sore throat: a systematic review

2016

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Summary Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre‐existing lung disease, prolonged duration of anaesthesia and the presence of a blood‐stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double‐lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i‐gel™ supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence.

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Section: Methodsmentioning

confidence: 95%

Section: Tracheal Intubation Sads Childrenmentioning

confidence: 99%

Postoperative sore throat: a systematic review

2016

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“…Two clinical studies investigating the effectiveness of flurbiprofen for the prevention of POST were eligible for inclusion in the review (Table 1). 40,41 Uztüre et al 41 evaluated the efficacy of flurbiprofen lozenges for preventing POST, hoarseness and dysphagia symptoms in patients in whom a ProSeal laryngeal mask airway (LMA) was inserted during general anesthesia. A single flurbiprofen lozenge, given 45 min before induction of anesthesia, effectively reduced the severity of early POST (30 min postoperatively) and dysphagia compared with placebo (p<0.05 for both).…”

Section: Post-operative Sore Throat (Post)mentioning

confidence: 99%

“…25,26 It is most commonly used at a dose of 8.75 mg, based on the results of a dose-ranging study that demonstrated linear dose-response relationships for effectiveness and adverse events at doses between 5.0 mg and 12.5 mg. 27 Its use for the symptomatic relief of pharyngitis of viral, bacterial, or unknown etiology has been assessed in a number of studies. 17,22,25,26,[28][29][30][31][32][33][34][35][36][37][38] It has also been evaluated for the relief of postoperative sore throat POST, [39][40][41] a common complication of general anesthesia 42 and tonsillectomy 43 that can negatively impact patients' postoperative comfort.…”

Section: Introductionmentioning

confidence: 99%

<p>Locally Delivered Flurbiprofen 8.75 mg for Treatment and Prevention of Sore Throat: A Narrative Review of Clinical Studies</p>

Looze

Shephard

Smith

2019

JPR

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Background: Antibiotics are inappropriately prescribed to many people with sore throat. As most cases of sore throat are viral and/or self-limiting, guidelines recommend symptomatic management as first-line treatment. This paper reviews the available clinical evidence for the efficacy and safety of low-dose (8.75 mg) flurbiprofen, locally delivered to the throat for the symptomatic management of pharyngitis/sore throat. Method: A literature search was performed on 27 February 2019 using PubMed. Studies that met the following criteria were included in a narrative review: (1) studies evaluating the effectiveness of flurbiprofen for pharyngitis/sore throat; (2) randomized controlled studies; (3) locally administered formulation of study drug/comparator; and (4) flurbiprofen administered at 8.75 mg dose (single-or multiple-dose administration). Results: A total of 17 papers were included in the review: 15 publications reporting data from nine unique clinical studies of flurbiprofen for acute pharyngitis, and two reporting studies of flurbiprofen for the prevention of postoperative sore throat (POST). Studies in acute pharyngitis demonstrated that single-and multiple-dose flurbiprofen 8.75 mg, locally administered in lozenge, spray or microgranule form, was well tolerated and provided early onset and long-lasting symptomatic relief from throat pain and soreness, sensation of swollen throat, difficulty swallowing, and other associated symptoms. This included patients with more severe symptoms, patients with confirmed Streptococcus A/C sore throat, and patients taking concomitant antibiotics. In addition, a single preoperative dose of flurbiprofen lozenge was shown to be effective for relieving early POST in patients undergoing general anesthesia. Conclusion: Locally administered, low-dose flurbiprofen offers a useful first-line treatment option for symptomatic relief in patients with "uncomplicated" acute pharyngitis/sore throat associated with upper respiratory tract infection, thus potentially helping to reduce unnecessary antibiotic prescribing. It also offers an effective preoperative treatment option for the reduction of early POST severity and incidence.

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“…Pharmacologic methods were also used, e.g. NSAID lozenges (flurbiprofen) ( 4 ), lidocaine gel or spray, topical steroid (betamethasone gel on LMA cuff), and intravenous dexamethasone. However, none of them significantly decreased the incidence of POST ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Lidocaine Inhalation and Intravenous Dexamethasone in Reducing Postoperative Sore Throat Frequency After Laryngeal Mask Insertion

et al. 2018

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BackgroundThe frequency of postoperative sore throat (POST) after laryngeal mask airway insertion (LMA) was relatively high. Lidocaine might reduce the pain and inflammatory response. Additionally, inhalation form might result in a better distribution, which results in a better airway analgesia and minimal systemic effect.ObjectivesTo compare the incidence of sore throat post LMA insertion after 1.5 mg/kg of lidocaine inhalation and 10 mg of intravenous dexamethasone.MethodsThis was a single-blinded randomized clinical trial, which included 128 patients who underwent ophthalmic surgery under general anesthesia with LMA insertion. Inclusion criteria were individuals 18 - 65 years old, ASA 1 or 2, Mallampati class I or II, and no sore throat before surgery. After University of Indonesia Research Ethical Committee approval and informed consent, all subjects were randomly divided into two groups: lidocaine inhalation group, which would receive lidocaine inhalation 2% 1.5 mg/kg (additional NaCl 0.9% until total 6 mL volume) and intravenous 2 mL NaCl 0.9%, and dexamethasone group, which would received NaCl 0.9% inhalation (6 mL volume) and dexamethasone 10 mg intravenously 10 minutes before LMA insertion. POST incidence and pain severity assessment were done 2 hours postoperatively. Statistical analysis were done with SPSS version 21.ResultsThere were 10.9% of subjects in the lidocaine inhalation group and 9.4% subjects in the dexamethasone group who suffer from POST postoperatively (P > 0.05). The median of POST pain in the lidocaine inhalation group was 0 (0 - 1), whereas in dexamethasone group it was 0 (0 - 3). This study did not find any side effects on both groups.ConclusionsLidocaine inhalation 1.5 mg/kg was proportional to intravenous dexamethasone 10 mg in reducing the incidence and severity of POST after LMA insertion.

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The Effect of Flurbiprofen on Postoperative Sore Throat and Hoarseness After LMA-ProSeal Insertion: A Randomised, Clinical Trial

Cited by 11 publications

References 17 publications

Postoperative sore throat: a systematic review

Postoperative sore throat: a systematic review

<p>Locally Delivered Flurbiprofen 8.75 mg for Treatment and Prevention of Sore Throat: A Narrative Review of Clinical Studies</p>

Comparison Between Lidocaine Inhalation and Intravenous Dexamethasone in Reducing Postoperative Sore Throat Frequency After Laryngeal Mask Insertion

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