Comparison of nebulized ketamine and magnesium sulfate for post-thyroidectomy sore throat relief

Background & objective: A widespread post-operative complication that can lead to serious discomfort and morbidity is sore throat, and it is usually linked to endotracheal intubation during general anesthesia (GA). We examined and compared the effects of nebulized magnesium with nebulized ketamine on the frequency and intensity of sore throat in the first 24 hr following thyroidectomy under GA. Methods: In this randomized clinical trial, 60 adult patients aged 18-55 years, were enrolled to receive either nebulized 50 mg ketamine, magnesium sulfate 250 mg, or normal saline. Each group consists of 20 patients, all categorized as American Society of Anesthesia I or II. The treatment was administered 15 min before the induction of anesthesia and the incidence. The severity of postoperative sore throat was evaluated, and the systolic, and diastolic blood pressure, heart rate, and blood oxygen saturation were examined. The measurement at the following time intervals of 0h, 2 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr post thyroidectomy. Result: The incidence of postoperative sore throat at 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr post-surgery was significantly higher in the normal saline group compared with the ketamine or magnesium sulfate group, the overall incidence of sore throat was 75%, 24.2%, and 32.1% respectively. Patients with both ketamine and magnesium groups showed less severity of sore throat at 2 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr post-surgery. No significant differences regarding the hemodynamics parameter between groups as well as per and post-nebulization. Conclusion: Both nebulizations of either ketamine or magnesium sulfate before surgery are effective for the attenuation of postoperative sore throat one day post-thyroidectomy, with no difference between the two agents. Abbreviations: BMI: Basal metabolic index, ETT: endotracheal tubes, GA: general anesthesia, NMDR: N-methyl D-aspartate receptors, POST: Postoperative sore throat Keywords: Ketamine; magnesium sulfate; nebulize; sore throat; thyroidectomy Citation: Al-awwady AN. Comparison of nebulized ketamine and magnesium sulfate for post-thyroidectomy sore throat relief. Anaesth. pain intensive care 2025;29(3):496-501. DOI: 10.35975/apic.v29i3.2776 Received: May 09, 2024; Revised: October 26, 2024; Accepted: January 01, 2025