Prophylactic use of intravenous dexamethasone in reducing the incidence of postoperative sore throat following general anaesthesia with endotracheal intubation at Muhimbili national hospital, Dar es salaam

Abstract

Background: Postoperative sore throat is a common complication that develops after mucosal damage by the endotracheal tube. It may be very distressing to the patient and thus undermining patient satisfaction due to discomfort experienced in the postoperative period. The present study examined the effects of prophylactic dexamethasone on the incidence of sore throat and severity of sore throat after extubation. Objective: To assess the effectiveness of prophylactic intravenous dexamethasone in reducing the incidence of postoperative sore throat in elective patients under general anesthesia with endotracheal intubation at Muhimbili National Hospital Methodology: A prospective, randomized double-blind study of intravenous dexamethasone using a dose of 0.1 mg/kg was conducted. A total of 92 patients aged 18-60 years of age with American Society of Anaesthesiologists physical status class I or II undergoing elective surgery under general anesthesia were enrolled and randomly allocated into two separate groups. One group (D1) received I.V dexamethasone 0.1 mg/kg 60 minutes before endotracheal intubation and the other group (D2) received placebo (normal saline) at the same time. The incidence and severity of sore throat was then evaluated postoperatively at 1, 6 and 24 hours. Results: The incidence of patients developing sore throat postoperatively at 1, 6 and 24 hours was statistically different between the two groups. The group of patients who received dexamethasone exhibited statistically significant lower incidences compared to the group of patients who received placebo (58.7% vs 95.6%; 21.7% vs 95.6%; 4.4% vs 69.6%) at 1, 6 and 24 hours respectively with the reduction of incidence sore throat by 36.9% during the first hour. In addition, the intensity of postoperative sore throat was less in the dexamethasone group than in the placebo group with statistically significant less proportion of patients experiencing moderate sore throat at 1 hour in the dexamethasone group.