Hoarseness after general endotracheal anesthesia: A single-center retrospective analysis

After the extubation of endotracheal tubes or removal of laryngeal masks in patients who underwent general anesthesia, complications such as hoarseness often occur, potentially leading to serious adverse effects on patients. Therefore, this study aimed to analyze the causes of hoarseness to provide improved prevention and treatment options.

We conducted a retrospective analysis of patients who underwent general anesthesia at the Renmin Hospital of Wuhan University from January 2017 to December 2021, excluding patients under 18 years of age, over 80 years old, with preoperative hoarseness and undergoing multiple surgeries. The incidence, duration, influencing factors and causes of hoarseness after tracheal intubation were analyzed.

The study found that the incidence of hoarseness after tracheal intubation was 11.77%. Of those patients experiencing hoarseness immediately after the operation, 79.56% could recover on the same day, 15.37% of patients could recover on the day after operation, 4.23% could recover within 3 days of the operation, and 0.83% of patients might need 5 or more days to recover. Patients aged 50 years and older, with an intubation time of more than 3 h, who underwent neck and cardiothoracic surgery, with a low BMI and with difficult airways exhibited a higher incidence of hoarseness after tracheal intubation. The main causes of hoarseness were vocal cord paralysis and arytenoid joint dislocation, with the number of patients at 8.97% (1106) and 7.32% (902) respectively. The incidences of hoarseness caused by psychological stress accounted for 4.15% of the cases. with a total of 512 patients affected.

Age, intubation time, surgical site, low BMI and difficult airway were important factors affecting hoarseness after intubation. The vocal cord paralysis and arytenoid joint dislocation were major causes of hoarseness.