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Title: Comparison of Preoperative Ketamine Nebulization versus Saline Nebulization in Decreasing the frequency and Severity of Postoperative Sore Throat
Authors: Muhammad Zeeshan Akbar, Naveed Farhat, Abdul Hameed Bhatti, Kenan Anwar Khan, Abdul Raafeh Jamal, Muhammad Muzzamil Saleem
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2024
Volume: 74
Issue: 4
Language: English
Keywords: KetamineNebulizationPharyngitisSore throat
Objective: To compare preoperative Ketamine nebulization versus saline nebulization in reducing the frequency and severity of sore throat postoperatively.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Bahawalpur Pakistan, from Jan to Jun 2022.
Methodology: A total of 120 patients (60 in each group) with different surgeries filling the inclusion criteria were considered in the study. Adult patients of 20-60 years with ASA class 1-2 who were planned for elective surgery of less than 2 hours were included. Group-A patients underwent nebulization with Ketamine while in Group-B nebulization was done with normal saline.
Results: A total of patients included were 120 (60 each group). Twenty-eight (23.3%) patients developed Post-Operative Sore Throat at some time after extubation. The frequency of Post-Operative Sore Throat with Ketamine was 13.3% and with saline it was 33.3%. Twenty (71.42%) patients of Post-Operative Sore Throat developed sore throat at 2 hours after extubation, of which 15 patients belong to Saline Group (p-value 0.01). Twenty-one patients of Post-Operative Sore Throat had mild sore throat of which 14 patients were of Saline Group (p-value 0.006).
Conclusion: Ketamine nebulization postoperatively leads to reduced frequency and severity of Post-Operative Sore Throat in early post-operative period in patients in which endotracheal intubation was done for GA.
To compare preoperative Ketamine nebulization versus saline nebulization in reducing the frequency and severity of sore throat postoperatively.
A quasi-experimental study was conducted with 120 adult patients (20-60 years, ASA class 1-2) undergoing elective surgery of less than 2 hours under general anesthesia with endotracheal intubation. Patients were divided into two groups: Group-A received nebulization with Ketamine (50mg in 1ml with 4ml normal saline) and Group-B received nebulization with normal saline (5ml) for 15 minutes before anesthesia induction. Postoperative sore throat (POST) was assessed at 0, 2, 6, 12, and 24 hours post-extubation using a 4-point scale. Data was analyzed using SPSS version 21, with percentages, frequencies, mean, standard deviation, and Chi-square test.
graph TD
A["Recruit 120 patients 20-60 yrs, ASA 1-2, <2hr surgery"] --> B["Randomly assign to Group A"Ketamine Nebulization" or Group B"Saline Nebulization""];
B --> C["Administer nebulization for 15 min pre-induction"];
C --> D["Induce general anesthesia and intubate"];
D --> E["Perform surgery"];
E --> F["Extubate and monitor for POST at 0, 2, 6, 12, 24 hours"];
F --> G["Collect and analyze POST data"];
G --> H["Compare frequency and severity of POST between groups"];
H --> I["Draw conclusion on Ketamine's efficacy"];
Postoperative sore throat (POST) is a common complication following endotracheal intubation, leading to patient dissatisfaction. The study's findings suggest that preoperative Ketamine nebulization is effective in reducing both the frequency and severity of POST compared to saline nebulization. This is attributed to Ketamine's anti-nociceptive and anti-inflammatory properties, which act on NMDA receptors to mitigate the inflammatory process in the throat. The results align with previous studies indicating the benefit of Ketamine in reducing POST.
Out of 120 patients, 28 (23.3%) developed postoperative sore throat. The frequency of POST was 13.3% in the Ketamine group and 33.3% in the saline group. Significantly fewer patients in the Ketamine group experienced POST at 2, 6, 12, and 24 hours post-extubation compared to the saline group (p-values 0.01, 0.02, 0.009, 0.009 respectively). Mild sore throat was observed in 17.5% of patients overall, with 23.3% in the saline group and 11.7% in the Ketamine group (p-value 0.006). Moderate sore throat was seen in 10% of the saline group and 1.7% of the Ketamine group (p-value < 0.001).
Preoperative Ketamine nebulization leads to a reduced frequency and severity of postoperative sore throat in the early postoperative period for patients who underwent endotracheal intubation for general anesthesia.
* Total patients included: 120 (60 in each group).
* Overall incidence of Postoperative Sore Throat (POST): 23.3% (28 out of 120 patients).
* Frequency of POST in Ketamine group: 13.3%.
* Frequency of POST in Saline group: 33.3%.
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