efficacy of ketamine gargle in prevention of postoperative sore throat in patients undergoing general anesthesia with endotracheal intubation, a 1 year double blinded placebo controlled randomized trial

Abstract

Background: Postoperative sore throat (POST) following extubation after general anaesthesia is one of the most distressing side effect of endotracheal intubation during the immediate postoperative period. Ketamine, a NMDA antagonist, has anti-nociceptive and anti-inflammatory properties. Through its action on the peripherally located NMDA receptors it reduces inflammation and pain. Objective: To assess the efficacy of ketamine gargle in prevention of postoperative sore throat in patients undergoing endotracheal intubation for general anaesthesia. Methodology: One year double blinded randomized controlled trial was conducted at KLE’S Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi between January 2014 and December 2014. 106 patients undergoing general anaesthesia with endotracheal intubation were included in our study and were randomised using computer generated randomisation table into Group A and B with 53 patients each. Group A received 50mg(1ml) of Ketamine diluted with 29 ml of normal saline in the form of a gargle and Group B received 30 ml normal saline 5 minutes before induction. Patients had to gargle for a period of 30 seconds. 4 patients were excluded from the study as they were unable to gargle for a period of 30 seconds. Results: Age, Gender distribution, Duration of procedure was comparable between the two groups. Gargling with 50 mg (1 ml) of ketamine diluted with 29 ml of normal saline 5 minutes before induction successfully reduces the incidence and severity of POST (post-operative sore throat). When compared the difference in the incidence of sore throat at 0, 4, 8, 12, 24 hours post extubation was found to be statistically significant (p< 0.001) Conclusion: Ketamine gargle significantly reduces the incidence and severity of postoperative operative sore throat.