Abstract
Purpose
Tracheal intubation for general anesthesia causes postoperative sore throat. The purpose of this study was to evaluate the effect of sevoflurane and desflurane on prevalence of postoperative sore throat in patients after general anesthesia.
Methods
Ninety-six patients scheduled for orthopedic lower extremity surgery under general anesthesia were assigned to sevoflurane group or desflurane group. In the sevoflurane group (n = 48), sevoflurane was used as a maintenance anesthetic agent. In the desflurane group (n = 48), desflurane was used. Prevalence of sore throat, number of patients with rescue analgesics, and analgesics requirements were evaluated.
Results
The overall prevalence of postoperative sore throat in the sevoflurane group was lower than that in the desflurane group [21 (44%) vs. 32 (67%), p = 0.024]. The prevalence of sore throat at postoperative 4 h in the sevoflurane group was lower than that in the desflurane group [6 (13%) vs. 18 (38%), p = 0.005]. The number of patients requiring rescue analgesics was lower in the sevoflurane group [25 (52%) vs. 36 (75%), p = 0.020]. The requirement of diclofenac was also lower in the sevoflurane group (30 ± 37 mg vs. 47 ± 40 mg, p = 0.031).
Conclusions
We have shown that sevoflurane was associated with less frequent sore throat than desflurane in patients undergoing orthopedic lower extremity surgery.
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References
Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999;89:652–8.
Sumathi PA, Shenoy T, Ambareesha M, Krishna HM. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Anaesth. 2008;100:215–8.
Maruyama K, Sakai H, Miyazawa H, Toda N, Iinuma Y, Mochizuki N, Hara K, Otagiri T. Sore throat and hoarseness after total intravenous anaesthesia. Br J Anaesth. 2004;92:541–3.
Park SH, Han SH, Do SH, Kim JW, Rhee KY, Kim JH. Prophylactic dexamethasone decreases the incidence of sore throat and hoarseness after tracheal extubation with a double-lumen endobronchial tube. Anesth Analg. 2008;107:1814–8.
Ayoub CM, Ghobashy A, Koch ME, McGrimley L, Pascale V, Qadir S, Ferneini EM, Silverman DG. Widespread application of topical steroids to decrease sore throat, hoarseness, and cough after tracheal intubation. Anesth Analg. 1998;87:714–6.
Seo JH, Cho CW, Hong DM, Jeon Y, Bahk JH. The effects of thermal softening of double-lumen endobronchial tubes on postoperative sore throat, hoarseness and vocal cord injuries: a prospective double-blind randomized trial. Br J Anaesth. 2016;116:282–8.
Borazan H, Kececioglu A, Okesli S, Otelcioglu S. Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study. Anesthesiology. 2012;117:512–8.
Zhao X, Cao X, Li Q. Dexamethasone for the prevention of postoperative sore throat: a systematic review and meta-analysis. J Clin Anesth. 2015;27:45–50.
Song D, Joshi GP, White PF. Fast-track eligibility after ambulatory anesthesia: a comparison of desflurane, sevoflurane, and propofol. Anesth Analg. 1998;86:267–73.
TerRiet MF, DeSouza GJ, Jacobs JS, Young D, Lewis MC, Herrington C, Gold MI. Which is most pungent: isoflurane, sevoflurane or desflurane? Br J Anaesth. 2000;85:305–7.
White PF, Tang J, Wender RH, Yumul R, Stokes OJ, Sloninsky A, Naruse R, Kariger R, Norel E, Mandel S, Webb T, Zaentz A. Desflurane versus sevoflurane for maintenance of outpatient anesthesia: the effect on early versus late recovery and perioperative coughing. Anesth Analg. 2009;109:387–93.
Naidu-Sjosvard K, Sjoberg F, Gupta A. Anaesthesia for videoarthroscopy of the knee. A comparison between desflurane and sevoflurane. Acta Anaesthesiol Scand. 1998;42:464–71.
Jellish WS, Owen K, Edelstein S, Fluder E, Leonetti JP. Standard anesthetic technique for middle ear surgical procedures: a comparison of desflurane and sevoflurane. Otolaryngol Head Neck Surg. 2005;133:269–74.
Rajesparan K, Biant LC, Ahmad M, Field RE. The effect of an intravenous bolus of tranexamic acid on blood loss in total hip replacement. J Bone Jt Surg Br. 2009;91:776–83.
Wolinsky PR, McCarty EC, Shyr Y, Johnson KD. Length of operative procedures: reamed femoral intramedullary nailing performed with and without a fracture table. J Orthop Trauma. 1998;12:485–95.
El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: a systematic review. Anaesthesia. 2016;71:706–17.
Mapleson WW. Effect of age on MAC in humans: a meta-analysis. Br J Anaesth. 1996;76:179–85.
Harding CJ, McVey FK. Interview method affects incidence of postoperative sore throat. Anaesthesia. 1987;42:1104–7.
Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U. Ketamine gargle for attenuating postoperative sore throat. Br J Anaesth. 2008;100:490–3.
Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane and desflurane: a systematic review. Anesth Analg. 2004;98:632–41 (table of contents).
Rortgen D, Kloos J, Fries M, Grottke O, Rex S, Rossaint R, Coburn M. Comparison of early cognitive function and recovery after desflurane or sevoflurane anaesthesia in the elderly: a double-blinded randomized controlled trial. Br J Anaesth. 2010;104:167–74.
Yoon IJ, Kang H, Baek CW, Choi GJ, Park YH, Jung YH, Woo YC, Lee S. Comparison of effects of desflurane and sevoflurane on postoperative nausea, vomiting, and pain in patients receiving opioid-based intravenous patient-controlled analgesia after thyroidectomy: propensity score matching analysis. Medicine (Baltim). 2017;96:e6681.
Smiley RM. An overview of induction and emergence characteristics of desflurane in pediatric, adult, and geriatric patients. Anesth Analg. 1992;75:38–44 (discussion S-6).
Sugasawa Y, Yamaguchi K, Kumakura S, Murakami T, Suzuki K, Nagaoka I, Inada E. Effects of sevoflurane and propofol on pulmonary inflammatory responses during lung resection. J Anesth. 2012;26:62–9.
Lee HT, Kim M, Jan M, Emala CW. Anti-inflammatory and antinecrotic effects of the volatile anesthetic sevoflurane in kidney proximal tubule cells. Am J Physiol Renal Physiol. 2006;291:F67–78.
Schilling T, Kozian A, Kretzschmar M, Huth C, Welte T, Buhling F, Hedenstierna G, Hachenberg T. Effects of propofol and desflurane anaesthesia on the alveolar inflammatory response to one-lung ventilation. Br J Anaesth. 2007;99:368–75.
Koksal GM, Sayilgan C, Gungor G, Oz H, Sen O, Uzun H, Aydin S. Effects of sevoflurane and desflurane on cytokine response during tympanoplasty surgery. Acta Anaesthesiol Scand. 2005;49:835–9.
De Oliveira GS Jr, Fitzgerald PC, Ahmad S, Marcus RJ, McCarthy RJ. Desflurane/fentanyl compared with sevoflurane/fentanyl on awakening and quality of recovery in outpatient surgery using a laryngeal mask airway: a randomized, double-blinded controlled trial. J Clin Anesth. 2013;25:651–8.
Brimacombe J. The advantages of the LMA over the tracheal tube or facemask: a meta-analysis. Can J Anaesth. 1995;42:1017–23.
Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis. 2018;9:143–50.
Goren O, Matot I. Perioperative acute kidney injury. Br J Anaesth. 2015;115(Suppl 2):ii3–14.
Funding
This research was supported by the Keimyung University Research Grant of no. 20180264.
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Park, JH., Lee, YC., Lee, J. et al. Influence of intraoperative sevoflurane or desflurane on postoperative sore throat: a prospective randomized study. J Anesth 33, 209–215 (2019). https://doi.org/10.1007/s00540-018-2600-y
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DOI: https://doi.org/10.1007/s00540-018-2600-y