JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Park, S.-H. Articles by Kim, J.-H. Search for Related Content PubMed PubMed Citation Articles by Park, S.-H. Articles by Kim, J.-H. Related Collections Cardiovascular Airway Complications Clinical Pharmacology Pharmacology

---

CARDIOVASCULAR ANESTHESIOLOGY

Prophylactic Dexamethasone Decreases the Incidence of Sore Throat and Hoarseness After Tracheal Extubation with a Double-Lumen Endobronchial Tube

Sang-Hyun Park, MD^*, Sung-Hee Han, MD, PhD^*, Sang-Hwan Do, MD, PhD^*, Jung-Won Kim, MD, PhD, Ka-young Rhee, MD, PhD, and Jin-Hee Kim, MD, PhD^*

From the *Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam City, Kyeonggi-do; Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang City, Kyeonggi-do; and Department of Anesthesiology and Pain Medicine, Konkuk University School of medicine, Seoul, Korea.

Address correspondence and reprint requests to Jin-Hee Kim, MD, PhD, Department of Anesthesiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Seongnam City, Kyeonggi-do, 463-802, Korea. Address e-mail to anesing1{at}snu.ac.kr.

Abstract

BACKGROUND: Postoperative sore throat and hoarseness are common complications after tracheal intubation, particularly after using a double-lumen endobronchial tube (DLT). We conducted a prospective, randomized, double-blind, placebo-controlled study to evaluate the efficacy of dexamethasone for reducing the incidence and severity of postoperative sore throat and hoarseness.

METHODS: One hundred sixty-six patients (aged 18–75 yr) scheduled for thoracic surgery with a DLT were enrolled. Before induction of general anesthesia, 0.1 mg/kg dexamethasone (Group D1), 0.2 mg/kg dexamethasone (Group D2), or a placebo (Group P) were infused IV in a double-blind and prospectively randomized manner. Glottic exposure as defined by Cormack and Lehane score, resistance to DLT insertion, number of intubation attempts, time to achieve intubation, and the duration of tracheal intubation were recorded. At 1 h and 24 h after tracheal extubation, the patients were evaluated for sore throat and hoarseness using a visual analog scale (VAS; where 0 = no pain and 100 = worst pain imaginable).

RESULTS: One hour after tracheal extubation, the incidence of postoperative sore throat and hoarseness, along with the severity of sore throat were lower in Group D1 (31%, P = 0.021; 11%, P = 0.003; and VAS 12.4, P < 0.001, respectively) and D2 (11%, P = 0.001; 4%, P = 0.001; and VAS 6.6, P < 0.001, respectively) compared with Group P (53%, 36% and VAS 30.9, respectively). Twenty-four hours after tracheal extubation, the incidence of postoperative sore throat, hoarseness, and the severity of sore throat were significantly lower in Group D2 (27%, P = 0.002; 15%, P = 0.001; and VAS 29.9, P < 0.002, respectively) compared with Group D1 (47%, 31%, and VAS = 43.9, respectively) and Group P (57%, 45%, and VAS = 51.3, respectively). There was no complication associated with the dexamethasone administration.

CONCLUSION: The prophylactic use of 0.2 mg/kg of dexamethasone significantly decreases the incidence and severity of sore throat and hoarseness 1 h and 24 h after tracheal extubation of a DLT.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999