POST- Post-Operative Sore Throat: Do I Spray or Nebulize?

Background- Postoperative Sore Throat (POST) is an unpleasant complaint after endotracheal intubation. It can be prevented altogether with simple measures like either spray or nebulization with lignocaine. Methods- In this prospective randomized study250 consenting patients (18-60 years, ASA I &II) were studied for POST after intubation. The two groups, group N and S received either preoperative nebulization with lignocaine 4% (1ml)in 4 ml of saline and 2 puffs of normal saline during intubation or nebulization with normal saline prior and lignocaine spray 10% (2 puffs) during intubation. Results- Heart rate (HR) was consistently more in group N when observed at pre-nebulization (p=0.039), during nebulization (p= 0.022), on operation table (p=0.001), during induction (p<0.001), and at various intraoperative intervals. Mean Arterial Pressure (MAP) remained largely comparable in two groups (p=0.001). Oxygen saturation and sedation scores were similar across two groups. Postoperatively, HR (p<0.01) and MAP (p<0.05) varied significantly during study duration. SpO2 and sedation levels were comparable (p<0.05). Group N reported less severity of sore throat (p<0.05) at 2, 4, 6 hours postoperatively and both groups showed similar resolution of sore throat at 12 and 24 hours. The Pearson Chi-Square test value of 1.641 and 0.672 (p=0.650 and 0.715), indicated no statistically significant difference in sore throat severity between males and females respectively in Groups N and S. Conclusion- Group N had lower incidence and severity of sore throat in the early postoperative period, and symptoms resolved by 12-24 hours. Heart rate and MAP were higher and sedation and saturation was maintained throughout. Keywords- Postoperative sore throat (POST), Nebulization, Lignocaine spray.