The Effect of Controlled Hypotensive Anesthesia on Postoperative Sore Throat

Objective: Postoperative sore throat (POST) is a commonly encountered and significant complication following anesthesia, which can adversely affect the quality of a patient's recovery. Airway devices such as endotracheal tubes (ETT) and laryngeal masks, used to maintain airway patency in patients undergoing general anesthesia, are important contributing factors in the development of POST. Controlled hypotension (CH) is a technique employed during surgery to reduce blood flow within the surgical field, enhance visibility and shorten the procedure duration by safely lowering the patient's blood pressure to a level that does not compromise perfusion indices. In this study, we aimed to investigate the effects of CH on POST, coughing, hoarseness, and vomiting in patients undergoing surgery in a supine position with a fixed endotracheal cuff pressure. Method: A total of 124 patients aged between 18 and 65 years, classified as ASA (American Society of Anesthesiologists) class I-II and scheduled for elective surgical procedures, were included in the study. The patients were divided into two groups: Group N (n=65), consisting of normotensive individuals, and Group H (n=59), which included patients subjected to CH. In both groups, the endotracheal cuff pressure was manually set to 25 cmH2O using a cuff pressure manometer. CH was achieved in Group H by administering glyceryl trinitrate (nitroglycerin) infusion, maintaining the mean arterial pressure (MAP) within the range of 55-65 mmHg. Patients were assessed for POST, coughing, hoarseness, and vomiting at postoperative 15 minutes, 2, 6, 12, and 24 hours. Results: Demographic data, smoking status, ASA scores, surgical and anesthesia durations were similar between the groups. Statistically significant differences were observed between the groups in the numeric rate scores (NRS) for throat pain at 15 minutes and 2 hours, as well as hoarseness scores at 2 and 6 hours. The groups were similar in terms of vomiting rates and cough scores. Conclusion: In this study investigating the impact of CH on sore throat, we observed an increased incidence of POST and hoarseness in patients subjected to CH. We believe that further research is necessary to determine the ideal endotracheal cuff pressure value for patients undergoing CH anesthesia.