Abstract
Purpose
To evaluate prospectively the incidence and severity of postoperative sore throat in 63 orotracheally intubated patients undergoing general anesthesia for various surgical procedures and to determine whether postoperative sore throat could be attenuated by treatment with the transdermal nonsteroidal anti-inflammatory drug ketoprofen applied on the anterior skin of the neck during operation.
Method
Patients were randomly assigned to have treatment with ketoprofen (ketoprofen group) or to have placebo tape treatment (control group). Postoperative analgesia was obtained by continuous epidural infusion of local anesthetics, and no narcotics were administered intraoperatively or postoperatively. All patients were interviewed postoperatively after 12–20 hr using a scoring scale questionnaire. Sore throat was scored as 0 = no sore throat, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe.
Results
In the control group, 16 of 32 patients had a sore throat. In the ketoprofen group, less patients (ten of 31 patients) had a sore throat (not significant). The severity of sore throat was alleviated significantly in the ketoprofen group (P < 0.05).
Conclusion
This study suggests the pain caused by tracheal intubation is relieved by intraoperative topical use of transdermal ketoprofen.
Résumé
Objectif
Évaluer de façon prospective l’incidence et la sévérité du mal de gorge postopératoire chez 63 patients soumis à une intubation oro-trachéale et à une anesthésie générale pour différentes interventions chirurgicales. Aussi, déterminer si le mal de gorge postopératoire peut être limité par un traitement avec un anti-inflammatoire non stéroïdien transdermique, le kétoprofène, appliqué sur la peau de la face antérieure du cou pendant l’opération.
Méthode
Les patients ont été répartis au hasard et ont reçu le kétoprofène (groupe kétoprofène) ou une bande placebo (groupe témoin). L’analgésie postopératoire a été obtenue par une perfusion épidurale continue d’anesthésiques locaux. Aucun narcotique n’a été administré pendant ou après l’opération. Tous les patients ont répondu, 12–20 h après l’opération, à un questionnaire doté d’une échelle de cotation. Le mal de gorge était coté comme suit: 0 = aucun mal de gorge, 1 = minime, 2 = léger, 3 = modéré, 4 = sévère.
Résultats
Dans le groupe témoin, 16 des 32 patients ont eu un mal de gorge. Dans le groupe kétoprofène, dix des 31 patients ont eu une mal de gorge (non significatif). La sévérité de cet inconfort a été significativement réduite avec le kétoprofène (P < 0,05).
Conclusion
La présente étude suggère que la douleur causée par l’intubation endotrachéale est soulagée par l’usage topique peropératoire de kétoprofène transdermique.
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References
Blanc VF, Tremblay NAG. The complications of tracheal intubation: a new classification with a review of the literature. Anesth Analg 1974; 53: 202–13.
Riding JE. Minor complications of general anaesthesia. Br J Anaesth 1975; 47: 91–101.
Shah MV, Mapleson WW. Sore throat after intubation of the trachea. Br J Anaesth 1984; 56: 1337–41.
Christensen AM, Willemoes-Larsen H, Lundby L, Jakobsen KB. Postoperative throat complaints after tracheal intubation. Br J Anaesth 1994; 73: 786–7.
Monroe MC, Gravenstein N, Saga-Rumley S. Postoperative sore throat: effect of oropharyngeal airway in orotracheally intubated patients. Anesth Analg 1990; 70: 512–6.
Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. BMJ 1984; 288: 965–8.
Stanley TH. Nitrous oxide and pressures and volumes of high- and low-pressure endotracheal-tube cuffs in intubated patients. Anesthesiology 1975; 42: 637–40.
Saarnivaara L, Grahne B. Clinical study on an endotracheal tube with a high-residual volume, lowpressure cuff. Acta Anesthesiol Scand. 1981; 25: 89–92.
Jensen PJ, Hommelgaard P, Søndergaard P, Eriksen S. Sore throat after operation: influence of tracheal intubation, intracuff pressure and type of cuff. Br J Anaesth 1982; 54: 453–7.
Mandøe H, Nikolajsen L, Lintrup U, Jepsen D, Mølgaard J. Sore throat after endotracheal intubation. Anesth Analg 1992; 74: 897–900
Loeser EA, Bennett GM, Orr DL, Stanley TH Reduction of postoperative sore throat with new endotracheal tube cuffs. Anesthesiology 1980; 52: 257–9.
Thomas DV. Hoarseness and sore throat after tracheal intubation. Small tubes prevent (Letter). Anaesthesia 1993; 48: 355–6
Stenqvist O, Nilsson K. Postoperative sore throat related to trachéal tube cuff design. Can Anaesth Soc J 1982; 29: 384–6.
Ayoub CM, Ghobashy A, Koch ME, et al. Widespread application of topical steroids to decrease sore throat, hoarseness, and cough after tracheal intubation. Anesth Analg 1998; 87: 714–6.
El-Hakim M. Beclomethasone prevents postoperative sore throat. Acta Anaesthesiol Scand 1993; 37: 250–2
Fuller PB. The relationship between preintubation lidocaine and postanesthesia sore throat. J Am Ass Nurs Anesth 1992; 60: 374–8.
Fossgreen J. Ketoprofen. A survey of current publication. Scand J Rheumatol 1976; 14: 7–32.
Basto ER, Waintrop C, Mourey FD, Landru JP, Eurin BG, Jacob LP. Intravenous ketoprofen in thyroid and parathyroid surgery. Anesth Analg 2001; 92: 1052–7.
Cordero JA, Alarcon L, Escribano E, Obach R, Domenech J. A comparative study of the transdermal penetration of a series of nonsteroidal antiinflammatory drugs. J Pharm Sci 1997; 86: 503–8.
Nguyen Tu H, Saidi N, Lieutaud T, Bensaid S, Menival V, Duvaldestin P. Nitrous oxide increases endotracheal cuff pressre and the incidence of tracheal lesions in anesthetized patients. Anesth Analg 1999; 89: 187–90.
Harding CJ, McVey FK. Interview method affects incidence of postoperative sore throat. Anaesthesia 1987; 42: 1104–7.
Insel PA. Analgesic-antipyretics and antiinflammatory agents; drugs employed in the treatment of rheumatoid arthritis and gout.In: Gilman AG, Rall TW, Nies AS, Taylor P (Eds.). Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 8th ed., New York: Pergamon Press, Inc., 1990: 638–81.
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Ozaki, M., Minami, K., Sata, T. et al. Transdermal ketoprofen mitigates the severity of postoperative sore throat. Can J Anesth 48, 1080–1083 (2001). https://doi.org/10.1007/BF03020373
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DOI: https://doi.org/10.1007/BF03020373