Postoperative sore throat (POST) is a frequent complaint following endotracheal intubation with incidence rates varying from 14.4% to 61%. Regardless of the incidence or duration, POST is rated as a patient’s 8th most undesirable outcome in the postoperative period, and is certainly an opportunity to improve patient outcomes.

Background and Objectives: Various nonpharmacological and pharmacological trials have been used for attenuating POST with variable success. The aim of the present study was to compare the effect of ketamine, tramadol and 1.5% saline gargle in prevention of postoperative sore throat.

Methods and Material: Following institutional ethical committee approval and written informed consent, a prospective randomized doubleblinded study was conducted in 100 cases divided into four groups of 25 patients in each group. Patients included in the study were of age group 1860 years, ASA grade III, undergoing elective surgeries with duration of surgery approximately 2 hrs or more requiring tracheal intubation. Patients were allocated randomly to four groups, Group A, Group B, Group C and Group D. After shifting patient to operation theatre 5 mins prior to induction of anesthesia, Group A received 30ml of normal saline, Group B preservative free ketamine 1ml (50 mg) in 29 ml of normal saline, Group C received tramadol 1ml(50 mg) in 29ml normal saline and Group D received 30ml of 1.5% saline to gargle for 30 seconds. Postoperatively presence of sore throat was noted at rest and on swallowing immediately after extubation, at 2 h, 4 h, and 24 h.

Statistical Analysis Used: IBMSPSS_21 was used for statistical analysis.

Results: There was no significant difference in POST at rest (Figure 1) at 0 hr, 4 hr and 24 hr postoperatively among the four groups. Incidence of POST at rest at 2hr was significantly lower in ketamine group. Ketamine caused significant reduction in POST at swallowing (Figure 2) at 2 & 4hrs. Tramadol caused significant reduction at 2 & 4 hrs. 1.5% saline caused significant reduction in POST at swallowing at 2hrs.

Conclusions: Among all the groups ketamine was found to be most effective in prevention of POST followed by tramadol. Based on the risk estimate analysis even 1.5% saline reduces incidence of POST.