A comparative study of three nebulized medications for the prevention of postoperative sore throat in the pediatric population

Abstract

Background: The delivery of aerosolized drugs is a vital component of treatment for many respiratory disorders. We used this mode of medication delivery as a pre-emptive strategy to alleviate a Postoperative Sore Throat (POST) in children receiving general anesthesia. Objectives: The primary aim of the study was to compare the effects of prophylactic ketamine, magnesium sulfate and dexamethasone nebulization, on the intensity of POST. Methods: Through a prospective, randomized, double-blind study, data were collected from children (6-16 years) undergoing surgeries from March 2018 to May 2018. The patients were allocated into 3 equivalent groups (36 patients each). Preoperative nebulization was performed for all patients. Group M received 40 mg/kg magnesium sulphate, group K received 1 mg/kg ketamine, and group D received 0.16 mg dexamethasone. The primary outcome of the study was the incidence and intensity of POST at the 4 th postoperative hour. The secondary outcomes included evaluation of adverse effects specifically nausea, vomiting, postoperative cough and postoperative sedation. Results: Patients in the K group had the lowest incidence of POST compared to patients in groups M and D, specifically, at the 4 th -postoperative hour (p-value = 0.003). Conclusions: Preoperative nebulization with ketamine was more effective in reducing the intensity of POST in pediatric patients postoperatively without systemic adverse effects.