Comparative Efficacy of Two Doses of Preoperative Budesonide Nebulization in Preventing Postoperative Sore Throat Following Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Background: Postoperative sore throat (POST) is a frequent complication after general anesthesia with endotracheal intubation, contributing to patient discomfort and dissatisfaction. This study evaluated the efficacy of single preoperative nebulization with two different doses of budesonide (250 and 500 µg) in reducing POST, cough, and hoarseness of voice in patients undergoing laparoscopic cholecystectomy (LC). Materials and Methods: In this randomized controlled trial, 150 adult patients (American Society of Anesthesiologists I–II) scheduled for elective LC were divided equally into three groups: Group N (normal saline), Group B1 (budesonide, 250 µg), and Group B2 (budesonide, 500 µg). Nebulization was administered 30 min before induction. POST, cough, and hoarseness of voice were assessed at extubation, 4, 12, and 24 h postoperatively using a standardized scoring system. Results: Group B1 and B2 showed significantly reduced incidence of POST at extubation ( P = 0.001 for both vs. control) and at 4 h ( P = 0.002 and P = 0.001, respectively). Cough incidence was also significantly reduced at extubation ( P = 0.003 for B1, P = 0.002 for B2) and at 4 h ( P = 0.004 and P = 0.003, respectively). Hoarseness of voice was significantly lower in Group B2 compared to B1 at extubation ( P = 0.026) and at 4 h ( P = 0.031). No significant intergroup differences were observed at 12 and 24 h ( P > 0.05). Conclusion: Preoperative nebulization with budesonide, at both 250 and 500 µg doses, effectively reduces early POST and cough. The higher dose offers additional benefit in reducing hoarseness of voice.