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Indian Journal of Anesthesia and Analgesia

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Efficacy of Ketamine Gargle for Attenuating Post-Operative Sore Throat in Patient Undergoing General Anaesthesia with Endotracheal Intubation

U. Muralikrishnan, Additional Professor and Head, Department of Anesthesia, Government Medical College, Kottayam, Kerala - 686008, India. , U. Muralikrishnan1 , Susha T.S.2

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Indian Journal of Anesthesia and Analgesia 4(4):p 1215-1222, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.48

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Abstract

Background and Objective: Postoperative sore throat (POST) is a common complication of general anaesthesia with endotracheal intubation that affects patient satisfaction after surgery. Postoperative sore throat following tracheal intubation is due to trauma to the airway mucosa. The reported incidence of postoperative sore throat varies from 21-65%. Various pharmacological and nonpharmacological agents have been used for attenuating postoperative sore throat with variable success. Ketamine, a NMDA antagonist, is involved with antinociception and anti-inflammatory cascade with “anti-hyperalgesic’,’ anti-allodynic’ and possibly opioid ‘tolerance-protective’ effect due to an additive effect with opioids reducing wind up and central sensitization by postsynaptic NMDA blockade. Methodology: 64 patients aged between 18 to 59 years, scheduled for various elective surgical procedures undergoing endotracheal intubation belonging to ASA I-II satisfying the criteria were randomly assigned into 2 groups of 32 each. Group C: Drinking water gargle- 30ml (placebo) for 40 seconds, 5 minutes before induction. Group K: Ketamine gargle (1mL=50 mg in 29 mL drinking water) for 40 seconds, 5 minutes before induction. Results: The overall incidence of post-operative sore throat in the control group (Group C) of our study population was 96.9%. The overall incidence of post-operative sore throat was positively less in Ketamine gargle group (Group K) with 53.1% when compared to 96.9% in the control group (Group C). There was a significant decrease in the incidence of post-operative sore throat seen in the Ketamine gargle group at 4, 8 and 24 hours after extubation. Conclusion: Ketamine gargle (50 mg ketamine =1 mL in 29 mL of drinking water) for 40 seconds, 5 minutes before induction of anaesthesia is a useful adjunct to decrease post-operative sore throat after endotracheal intubation.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.48

Keywords

Post-Operative Sore Throat; Endotracheal Intubation; Ketamine Gargle. 

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