Postoperative Sore Throat Following Double-lumen Tube Insertion in Adults Undergoing Surgery: A Scoping Review

Double-lumen tubes (DLTs) are associated with a high incidence of postoperative sore throat (POST). The aim of this scoping review was to map the current evidence for POST prevention following DLT use in adults and identify knowledge gaps. Literature search was conducted via standard electronic search engines. Randomized controlled trials (RCTs) involving adult patients undergoing surgeries with DLTs, where POST (incidence or severity) was reported as a primary outcome, were included. Twelve RCTs involving 1,632 patients were included in this review. Most studies were of good quality. The maximum incidence of POST (56.4%) and hoarseness of voice (44.3%) was present in the first postoperative hour in the control groups. Even at 24 hours, the incidence of POST was 31.2% in the control groups and 20% in the intervention groups. Several pharmacologic interventions, like benzydamine hydrochloride spray, intravenous dexamethasone, esketamine gargle, and superior laryngeal nerve blocks, were used to reduce POST following DLT use. Nonpharmacologic strategies, including the use of silicone DLTs, thermal softening techniques, and optimized intubation maneuvers, were also effective in reducing POST. With preemptive pharmacologic interventions, the incidence of POST ranged from 7.22% to 31% in the first hour, while for nonpharmacologic methods, the incidence was 30% to 45.9%. The review identified several areas where credible research is lacking, including the absence of studies focusing on patient-centric outcomes or the development of composite scoring systems. Similarly, there is minimal research on the use of artificial intelligence, simulation training, and three-dimensional printing to decrease POST following DLT use.