Postoperative sore throat

Abstract

Postoperative sore throat is one of the commonest complaints It, at times, becomes even more distressing than the pain due to the surgical procedure, but fortunately resolves within a few days by simple gargles and analgesics. Airway instrumentation and the number of attempts increase the incidence and severity of the postoperative sore throat. Young, female, overweight and procedures where there is neck manipulations like thyroid surgeries have a higher incidence. Plastic tubes are found to be better than the old red rubber tubes. The preformed tubes have an even lesser incidence than the standard tubes. Larger size tubes, high cuff pressure and improper use of stylets and suction catheters have also been implicated as a cause of postoperative sore throat. Lignocaine gell or steroid ointments also increase the incidence of this complaint, Even though, the incidence is less with the laryngeal mask airway, it is still quite common, especially if inserted fully deflated and the cuff pressure maintained above 60 cmH2O. By simple measures i,e; inserting the mask partially inflated and not increasing the cuff pressure beyond 60 cmH2O, we can help in reducing the incidence of this distressing complication, filling of the cuff with saline or a gas mixture of O2 and N2O and intermittent checks and adjustments of the cuff pressures are very helpful measures in preventing postoperative throat complications. Use of Korean acupuncture point and pro-operative azunol gargles are a significant recent advances in the prevention and treatment of postoperative sore throat. Postoperative hoarseness is also a distressing complaint. It may occur early due to vocal cord paralysis secondary to damage to the recurrent laryngeal nerve or late due to contact ulcer granuloma. Epithelial loss, Glottic haematoma, oedema, submucosal tear, epiglottitis and uvular bruising are some other pathological conditions associated with endotracheal intubation. Pharyngeal and oesophageal perforation are a few rare complications associated with endotracheal intubation with a rigid stylet. Lingual nerve neuropraxia causing loss of taste and difficulty in swallowing has been reported to be due to LMA cuff pressure. The incidence of dysphonea was higher with endotracheal intubation, and dysphagia was found to be more common with the LMA.