Postoperative sore throat: influence of tracheal tube lubrication versus cuff design

Abstract

The incidence and severity of postoperative sore throat was evaluated in six groups of 20 patients each after elective orthopedic surgery. Groups I to V had tracheal intubation with Portex disposable polyvinylchloride tracheal tubes and group VI had mask anaesthesia. All groups were exposed to heated humidified gases. Tracheal tubes in groups I-III were uncuffed and lubricated with four per cent lidocaine jelly (group I), four per cent lidocaine hydrochloride anaesthetic solution (group II) or normal saline (group III). Patients in group IV had unlubricated tubes with large residual volume cuffs, patients in group V unlubricated tubes with small residual volume cuffs and patients in group VI (mask anaesthesia) had the lowest incidence and severity of postoperative sore throat while those in group I had the highest incidence and most severe postoperative sore throats. Patients in group V had a lower incidence and severity of postoperative sore throat than patients in all other groups, except group VI. Postoperative sore throat was equally common and severe in patients in groups II, III, and IV. The data indicate that, with the use of heated humidified gases, tracheal intubation with either cuffed or uncuffed tubes produces a greater incidence and severity of postoperative sore throat than mask anaesthesia. In addition, our findings suggest that lubrication of tracheal tubes provides no advantage in terms of reducing postoperative sore throat and, depending on the lubricant, can increase the incidence and severity, Finally, our results demonstrate that the tracheal tube causing the least incidence and severity of postoperative sore throat is one with an unlubricated low residual volume cuff. © 1980 Canadian Anesthesiologists.