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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
Published on: January 13, 2017
Effects of benzydamine hydrochloride on postoperative sore throat after extubation in children: a randomized
Hyung-Been Yhim1, Soo-Hyuk Yoon1, Young-Eun Jang1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehakno, Jongnogu, Seoul, 03080, Korea.
Insights
Benzydamine hydrochloride spray did not reduce postoperative sore throat in children after endotracheal intubation. This study found no significant difference in sore throat incidence or pain between the benzydamine hydrochloride and control groups.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Pharmacology
Background:
- Postoperative sore throat (POST) is a common complication following endotracheal intubation.
- Effective strategies to mitigate POST in pediatric patients are needed.
Purpose of the Study:
- To evaluate the efficacy of benzydamine hydrochloride (BH) spray in reducing the incidence of POST in pediatric patients undergoing general anesthesia.
Main Methods:
- A randomized, double-blind, prospective study involving 142 children aged 6-12 years.
- Patients received either BH spray or a control intervention before endotracheal intubation.
- POST and adverse events were assessed in the post-anesthetic care unit.
Main Results:
- The incidence of POST was similar between the benzydamine hydrochloride group (59.2%) and the control group (49.3%), with no statistically significant difference (P=0.238).
- Postoperative pain levels and other complications were also comparable between the two groups.
Conclusions:
- Prophylactic application of benzydamine hydrochloride spray to the vocal cords and upper trachea did not effectively reduce the incidence of postoperative sore throat in pediatric patients.
- Further research may be needed to explore alternative or adjunct treatments for preventing POST in this population.
Background:
Postoperative sore throat (POST) is a common, undesirable result of endotracheal intubation during general anaesthesia. This study aimed to evaluate the effectiveness of benzydamine hydrochloride (BH) spray in reducing the incidence of POST in paediatric patients.
Methods:
This randomized, double-blind, prospective study included 142 children 6-12 years of age, who were randomly assigned to receive either BH spray or control. After induction of anaesthesia, direct laryngoscope was placed and BH spray was applied to the upper trachea and vocal cord in the BH group and intubation was performed using a cuffed tube lubricated with normal saline. Intubation in the control group was performed using a cuffed tube lubricated with normal saline without any intervention. The balloon was inflated to a pressure of 20 cmH2O. Patients were extubated after fully awakened and transferred to the post-anaesthetic care unit (PACU), where they were examined for the presence of POST and any adverse events 30 min after arrival to the PACU. Postoperative pain was evaluated using a smartphone application.
Results:
Seventy-one patients were allocated to each group. The incidence of POST in the BH group did not differ from that in the control group (control: BH = 35 (49.3%): 42 (59.2%); P = 0.238); postoperative pain was also similar between the groups. Other complications, such as breath holding, secretions, coughing, laryngospasm and desaturation events, did not differ between the groups.
Conclusions:
Application of prophylactic BH spray to the vocal cords and upper trachea was not proven to reduce POST in paediatric patients.
Trial Registry:
NCT03074968 (ClinicalTrials.gov, Feb 26, 2017).
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