Postoperative Sore Throat in the Postanesthetic Care Unit: Incidence, Contributing Factors, and Association With Airway Management

Introduction Postoperative sore throat (POST) is a frequent complication after general anesthesia with airway instrumentation. This study aimed to determine the incidence and severity of POST in patients admitted to the post-anesthesia care unit (PACU) of Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal, to compare these findings with published data, and to identify perioperative variables associated with increased or decreased risk. Methods A retrospective analysis of 106 adult patients undergoing general anesthesia with airway instrumentation was performed. POST severity was assessed using the Visual Analog Scale (VAS). Demographic, anesthetic, airway management, and pharmacologic variables were collected and analyzed for associations with POST. Results POST occurred in 21.7% of patients, with 5% reporting moderate pain, all following endotracheal intubation. Difficult laryngoscopy and multiple intubation attempts were significantly associated with a higher incidence and severity of POST. No pharmacologic intervention demonstrated a protective effect. Conclusions Mechanical airway factors, particularly difficult laryngoscopy and repeated intubation attempts, were the strongest predictors of POST. Optimizing intubation technique and achieving first-pass success remain key strategies to reduce this complication, while pharmacologic measures showed no significant benefit.