Comparative Evaluation of Magnesium Sulphate and Ketamine Gargles for Prevention of Post-operative Sore Throat Following ProSeal Laryngeal Mask Airway Insertion: A Prospective Randomized Study

Background: Post-operative sore throat (POST) is a common complication following laryngeal mask airway (LMA) insertion, often leading to patient discomfort and dissatisfaction. Various interventions have been proposed to mitigate this issue, including gargling with substances such as magnesium sulphate and ketamine. In this prospective, randomized study, we aimed to compare the efficacy of magnesium sulphate and ketamine gargles in preventing POST following ProSeal Laryngeal Mask Airway (PLMA) insertion. This comparative evaluation provided valuable insights into optimizing patient comfort and satisfaction in the perioperative period. Methods: We included seventy-five patients, aged 18-60, of any gender, with ASA I and II, scheduled for surgeries requiring general anesthesia with ProSeal laryngeal mask airway. Patients were randomly assigned to three groups: group-M (n=25) received magnesium sulphate gargle (1.2 g), group-K (n=25) received ketamine gargle (30 mg), and group-D (n=25) received dextrose gargle (20%). We recorded the number of attempts required for ProSeal insertion, nasogastric tube insertions, any blood staining of the ProSeal, post-operative sore throat incidence and severity at 0, 2, 4, and 24 hours, and any drug-related side effects. Results: The overall incidence of sore throat at 0, 2, 4, and 24 hours post-operatively was 12%, 16%, 20%, and 8%, respectively, in group-M, 20%, 28%, 28%, and 12%, respectively, in group-K, and 24%, 36%, 32%, and 12%, respectively, in group-D. Compared to group-D, sore throat incidence was significantly lower in group-M at 2 hours (p=0.023) and 4 hours (p=0.031), but no significant difference was observed between group-D and group-K. The severity of sore throat was significantly reduced in group-M at 0 hours (p=0.004), 2 hours (p=0.001), and 4 hours (p=0.001) compared to group-D, and in group-K at 2 hours (p=0.002) and 4 hours (p=0.001). However, compared to group-K, the severity of sore throat in group-M was significantly lower at 0 hours (p=0.049) and 2 hours (p=0.018). No significant side effects were observed. Conclusion: Magnesium sulphate gargling was more effective than ketamine gargling in reducing the incidence and severity of post-operative sore throat in patients undergoing general anesthesia with ProSeal laryngeal mask airway, without any observed side effects