Comparison of Preoperative Magnesium Sulphate and Budesonide Nebulisation in Reducing the Incidence and Severity of Postoperative Sore Throat- A Randomised Controlled Study

Abstract

Introduction: General anaesthesia with endotracheal intubation, being one of the most commonly performed procedures in clinical anaesthesiology, is not without adverse effects. Postoperative Sore Throat (POST) is one of the common adverse effects with a varying incidence. Prophylactic management of POST is recommended to improve the quality of postanaesthesia care and recovery. Aim: To evaluate the effectiveness of preoperative nebulisation with magnesium sulphate and budesonide in reducing the incidence and severity of POST. Materials and Methods: This randomised double-blinded control study was conducted in the Department of Anaesthesiology at Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India, from September 2020 to December 2021. The study included 120 patients, of either sex, aged between 20-60 years with American Society of Anesthesiologists (ASA) grade I and II posted for elective surgery requiring general anaesthesia with endotracheal intubation. The patients were randomly divided into three groups of 40 patients each. Group M was nebulised with 250 mg magnesium sulphate, Group B with 250 mcg budesonide and Group S was nebulised with normal saline, 15 minutes prior to the induction of anaesthesia. Incidence and severity of POST was documented at 0 hr, 2 hrs, 24 hrs and 48 hrs postextubation on a 0-3 score. Data collected was analysed using Statistical Package for Social Sciences (SPSS) version 22.0 and the results were then statistically analysed using Analysis of Variance (ANOVA) and Chi-square test. Results: The incidence of POST was more in saline group when compared with budesonide and magnesium sulphate group at all points of observation (0 hr, 2 hrs, 24 hrs and 48 hrs). The severity of POST was moderate in saline group while the other two groups experienced mild severity. This was statistically significant at 0 hr, 2 hrs and 24 hrs (p-value <0.05). But at 48 hrs severity of POST among the three groups was not significant. Conclusion: Preoperative nebulisation with magnesium sulphate and budesonide significantly reduces the incidence and severity of postoperative sore throat.

Keywords

• endotracheal intubation
• general anaesthesia
• prophylaxis