To Compare the Efficacy of Betamethasone Gel and Lignocaine Gel Applied over Endotracheal Tube to Reduce Post Operative Sore Throat and Cough

Background: Post-operative sore throat, cough and hoarseness of the voice are often common, uncomfortable sequelae after tracheal intubation with inflammation being the most common pathogenesis. Post operative sore throat and cough has a multifactorial aetiology that includes patient-related factors such as age, sex, and smoking, as well as intubation factors such as technique, duration, tube size, intracuff pressure, cuff design, trauma to the pharyngolaryngeal mucosa and various factors.

Objectives: To compare the incidence of post operative sore throat, cough after endotracheal tube intubation when applying betamethasone gel and lignocaine jelly.

Materials and Methods: At Saveetha Medical College and Hospital in Thandalam, Chennai, a prospective controlled double blinded study was done among patients who were scheduled for elective procedures under general anaesthesia with orotracheal intubation. The study comprised 60 patients who met the study's inclusion and exclusion criteria. The 60 patients were divided into two study groups each enrolled with 30 patients. Before the study could begin, approval from the institutional research board was required. Before the study began, an informed, written consent was obtained. The method used was Qualitative observational randomised double blind study by using a computer-generated random number table and the sealed envelope approach, patients were assigned to one of two equal groups.

Following a pre-anaesthetic evaluation, 60 patients of either sex, aged 18 to 60 years, with an ASA physical status of I or II, who were undergoing elective surgery (likely to last up to 240 minutes) under general anaesthesia with orotracheal intubation and met the above inclusion criteria were included in the study. The differences between the study groups were analysed by chi square test and the “p” value used as a cut off for estimating statistical significance between groups is 0.05.

Results: The incidence and severity of post operative sore throat and cough after endotracheal intubation during 6 and 24 hours was found to be statistically significantly in patients in whom betamethasone was used. The results are significant at p<0.05.

At 6 hours the incidence of post operative sore throat for betamethasone and lignocaine was 12% and 30% respectively. At 24 hours the incidence of post operative sore throat for betamethasone and lignocaine was 9.36% and 25.2% respectively.

At 6 hours the incidence of post operative cough for betamethasone and lignocaine was 8.4% and 24%.At 24 hours the incidence of post operative cough for betamethasone and lignocaine was 7.2% and 21.6% respectively.

Conclusion: The use of 0.05 percent betamethasone gel to lubricate the endotracheal tube before intubation helps to reduce the time it takes for symptoms to resolve.