Preventive Effect of Two Different Doses of Intravenous Dexamethasone on Sore Throat after Caesarean Section

Background: Sore throat after tracheal intubation is one of the unpleasant experiences of patients under general anesthesia, which can affect the patient's recovery and postoperative satisfaction. It is more common in the female sex after gynecological and obstetric surgeries. Physiological and anatomical changes during pregnancy result in intubation difficulty and subsequent sore throat. One of the prevention methods of this condition is the use of dexamethasone, which is a glucocorticoid with anti-inflammatory properties. This study aims to compare the effectiveness of two different dexamethasone doses (4 mg and 8 mg) in reducing post-operative sore throat after caesarean section. Methods: In a double-blinded randomized controlled trial (RCT), 90 candidates of caesarean section under general anesthesia were randomized to three groups receiving 8 mg of dexamethasone IV (Group I), 4 mg of dexamethasone IV (Group II), and 2 ml of normal saline (Group III) as a control group after the umbilical cord clamp. Then, through the VAS questionnaire, the rates of sore throat at one, 6, 12, and 24 hours after extubation were recorded and compared in three groups. Results: The average time of extubation in the 8 mg IV dexamethasone receiving group was significantly shorter than the normal saline receiving group (1.59 ± 5.13, P=0.007). The average severity of the sore throat at 6, 12, and 24 hours postoperatively was significantly different between the three groups. The severity of the sore throat in a group receiving 8 mg and 4 mg dexamethasone was significantly less than in the normal saline group (0.59 ± 0.19, P= 0.003 and 0.41 ± 0.19, P=0.036), respectively. Patient satisfaction was higher in the 8 mg dexamethasone-receiving group than in the other groups. Conclusion: Two doses of 8 and 4 mg of intravenous dexamethasone are effective in reducing the rate and severity of post-intubation sore throat after cesarean section under general anesthesia, and the dose of 8 mg is more effective than 4 mg, but this difference was not statistically significant.