Tracheal intubation and sore throat: a mechanical explanation

Abstract

SummaryAlthough tracheal intubation remains a valuable tool, it may result in pressure trauma and sore throat. The evidence for an association between these sequelae is not conclusive and sore throat may be caused at the time of intubation. This hypothesis was tested in a mechanical model and the results from tracheal intubation compared with those from insertion of a laryngeal mask airway, which is associated with a lower incidence of sore throat. Use of the model suggests that the tracheal tube and laryngeal mask airway impinge on the pharyngeal wall in different manners and involve different mechanisms for their conformation to the upper airway, but that in a static situation, the forces exerted on the pharyngeal wall are low with both devices. It also suggests that the incidence of sore throat should be lower for softer and smaller tracheal tubes and that the standard`Magill' curve (radius of curvature 140^20 mm) is about optimum for the average airway.

A comparison of postoperative sore throat after use of laryngeal mask airway and tracheal tube

“…However, it is not easy to identify the critical factors contributing to the difference in mucosal trauma and the severity of PST between LMAs and TTs because the LMA and the TT impinge on the pharyngeal wall in different manners and involve different mechanisms for their conformation to the upper airway [12]. Moreover, even with the use of a face mask for airway management, 8% of patients complained of sore throat [13,14].…”

Comparison of nebulized ketamine and ketamine with clonidine in postoperative sore throat

“…In present study total incidence of POST was 46% compared 18-65% in previous studies. 2 Out of which it was 6% in Group KC and (40%) in Group K, significantly less in Group KC (P=0.000).…”

“…1 The incidence is estimated to be of 18-65% in different studies. 2,3 Factors contributing to development of POST include trauma to pharyngolaryngeal mucosa from laryngoscopy, placement of nasogastric tube or oral suctioning. 4 The cuff design and pressure may affect tracheal mucosal capillary perfusion.…”

Intravenous dexamethasone versus ketamine gargle versus intravenous dexamethasone combined with ketamine gargle for evaluation of post-operative sore throat and hoarseness: A randomized, placebo-controlled, double blind clinical trial

“…It took 12 months to complete this study. The sample size was estimated from lower frame and with consideration the assurance level of 95% and power test of 80%, presuming the incidence of POST to be 65%,[1234567] and the effect of dexamethasone in reducing 27% of POST,[11] obtained 60 person but with considering that the surveying are four groups, sample size enrolled 35 patients in each group. Finally the sample size estimated 31 people in each group, for raising the assurance level and to compensate for potential dropouts, we enrolled 35 patients in each group.…”

“…The incidence of POST has been reported about 21-65%. [1234567] It may leave the patient with an unpleasant memory of the operation after discharge from the hospital. It had been rated by patients as the eighth most adverse effect in the post-operative period.…”