Preoperative Nebulization of Ketamine and Dexmedetomidine for Reduction in Postoperative Sore Throat: A Comparative Double-Blind Study

Background: One of the most prevalent procedures involving general anesthesia (GA) is endotracheal intubation, which can lead to a variety of airway complications. Patients undergoing GA with tracheal intubation may experience a common complication, known as postoperative sore throat (POST). We conducted this study to assess and compare the effectiveness of preoperatively administered nebulized ketamine and dexmedetomidine in alleviating POST. Methods: We randomly divided the patients into two groups, each containing 151 patients. Group-K patients were nebulized with 50 mg (1 ml) with 3 ml normal saline, while Group-D patients were nebulized with dexmedetomidine 50 mcg (0.5 ml) with 3.5 ml normal saline, preoperatively. GA was administered 15 min post-nebulization. POST was graded at 4, 6, 12, and 24 h after extubation on a four-point scale (0-3). The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 17.0. Results: In the present study, the overall incidence of POST was 32.5%. among which 39 patients (25.8%) in the ketamine group and 59 patients (39.1%) in the dexmedetomidine group experienced POST at 4h, following extubation (P value=0.014). A significantly higher incidence of POST in the dexmedetomidine group was noticed as compared to the ketamine group (P value < 0.05). But, at 6h, 12h, and 24h, the difference was not statistically significant between the two groups. A significantly larger percentage of cases in the dexmedetomidine group had more severe POST than in the ketamine group, at 4h following extubation (p-value <0.05). There was no significant rise in systolic and diastolic blood pressure in either group. However, the ketamine group had a significantly higher mean heart rate after extubation compared to the dexmedetomidine group. Conclusion: Ketamine nebulization significantly decreases the incidence and severity of postoperative sore throat during the early postoperative period with minimum hemodynamic changes.