Effects of Nebulization With Ketamine and Budesonide on Postoperative Sore Throat in Patients Undergoing Elective Surgeries Under General Anesthesia: A Randomized Controlled Comparative Clinical Study

Background Postoperative sore throat (POST) is a frequent issue after endotracheal intubation, caused by irritation and minor trauma to the throat. Various medications are used to prevent POST by reducing inflammation. This study evaluates the effectiveness of preoperative nebulization with ketamine and budesonide in minimizing POST over time. Methods This hospital-based, prospective, double-blinded randomized control trial was conducted with 100 patients aged 18 to 60 years undergoing elective surgeries requiring endotracheal intubation, aiming to compare the effectiveness of nebulization with ketamine and budesonide in reducing POST after oral endotracheal intubation. Patients were randomized into two groups, and POST was assessed using a four-point scale at multiple intervals post-extubation. Hemodynamic parameters were also monitored. Data were analyzed using IBM SPSS Statistics, with significance set at p < 0.05. Results In this study, the mean age of the participants was 41.34 ± 12.84 years in one group and 38.84 ± 13.95 years in the other. Heart rate (HR) readings were higher in the ketamine (Group K) group compared to the budesonide (Group B) group, although the difference was not statistically significant. A slight variation in mean arterial pressure (MAP) was observed between the groups at different time intervals. The incidence of sore throat was highest immediately after extubation but decreased over time. At zero hours, two patients in Group B and none in Group K had a sore throat. At two hours, four patients in Group K and five in Group B reported sore throats. At four hours, both groups had three patients with sore throats. At six hours, one patient in Group K and three in Group B reported sore throats. By 12 hours, only one patient in Group B had a sore throat, and none of the patients reported it at 24 hours. The ketamine group had a higher incidence of hallucinations compared to the budesonide group. Conclusion Nebulized ketamine and budesonide both effectively reduce POST, with ketamine showing lower severity but higher hallucination rates. Budesonide was associated with fewer complications, making it a preferable option for managing postoperative discomfort.