Efficacy of Lubrication of the Laryngeal Mask Airway with Benzydamine Hydrochloride Spray versus Chamomile Extract Spray for Prevention of Postoperative Sore Throat: a Randomized Controlled Trial

Main Article Content

Pamanee Saimuey
Ariyachart Kalawa
Suphalak Tipyotha
Thitinan Poottamat

Abstract

Background: Despite the i-gel® being considered less traumatic to the airway, the incidence of postoperative sore throat (POST) remains high. Various drugs, including benzydamine hydrochloride (BH) spray, have been studied for their ability to reduce POST, but no studies have examined the efficacy of chamomile extract spray. This study aims to compare the efficacy of BH and chamomile extract sprays in reducing the incidence of POST after general anesthesia (GA) with the i-gel®. Methods: In this randomized controlled trial, a total of 228 patients undergoing surgery under GA with the i-gel® were assigned into one of three groups. Prior to induction of anesthesia, the i-gel® was sprayed with 4 puffs of BH, chamomile extract, or normal saline in the BH, chamomile, and control groups, respectively. The primary objective of the study was to compare the incidence of POST among the three groups at 1, 4, and 24 hours after surgery. Results: The study found that the incidence of sore throat was significantly different at the 4th hour postoperatively, being lowest (28.4%) in the chamomile group and highest (50.0%) in the control group (P=0.023). Moreover, the severity of sore throat was significantly different between the chamomile and control groups at the 4th postoperative hour (P=0.015), while chamomile demonstrated greater efficacy than BH in reducing POST (RRR 43.0%, 15.0%, respectively). Conclusion: Spraying 4 puffs of chamomile extract on the i-gel® before insertion effectively reduces incidence and severity of POST at 4-hour post-surgery

Article Details

Section
Original articles

References

Piriyapatsom A, Dej-Arkom S, Chinachoti T, Rakkarnngan J, Srishewachart P. Postoperative sore throat: incidence, risk factors, and outcome. J Med Assoc Thai. 2013;96:936-42.

L’Hermite J, Dubout E, Bouvet S, et al. Sore throat following three adult supraglottic airway devices. Eur J Anaesthesiol. 2017;34:417-24.

Kati I, Tekin M, Silay E, Huseyinoglu UA, Yildiz H. Does benzydamine hydrochloride applied preemptively reduce sore throat due to laryngeal mask airway? Anesth Analg. 2004;99:710-2.

Gilani MT, Soleimani IM, Razavi M, Salehi M. Reducing sore throat following laryngeal mask airway insertion: comparing lidocaine gel, saline, and washing mouth with the control group. Braz J Anesthesiol. 2015;65:450-4.

Chia YY, Lee SW, Liu K. Propofol causes less postoperative pharyngeal morbidity than thiopental after the use of a laryngeal mask airway. Anesth Analg. 2008;106:123-6.

Uzture N, Menda F, Bilgen S, Keskin O, Temur S, Koner O. The effect of flurbiprofen on postoperative sore throat and hoarseness after LMA-ProSeal insertion: a randomised, clinical trial. Turk J Anaesthesiol Reanim. 2014;42:123-7.

Kiran S, Goel M, Singhal P, Gupta N, Bhardwaj M. Postoperative sore throat with 0.05% betamethasone gel and 2% lignocaine jelly used as a lubricant for ProSeal LMA (PLMA) insertion. Egypt J Anaesth. 2012;28:139-42.

Manuwong S, Direksuntorn S, Curry P. Efficacy of Brazilian Green Propolis extract in prevention of postoperative sore throat after endotracheal intubation. Thai J Anesthesiol. 2023;49:81-90.

Earsakul A, Laosuwan P, Benchapun A, Pattanapichakorn J. A comparative study of postoperative sore throat following insertion of laryngeal mask airway applied with water-soluble gel versus benzydamine hydrochloride spray. Thai J Anesthesiol. 2017;43:281-8.

Chairatthanawanit S, Piriyapatsom A, Hemmaraj P, Jirachaipitak S, Maneekat N, Suphathamwit A. Benzydamine hydrochloride spray for reducing postoperative sore throat after general anesthesia with laryngeal mask airway. J Med Assoc Thai. 2017;100(Suppl7):S101-6.

Srivastava JK, Shankar E, Gupta S. Chamomile: a herbal medicine of the past with a bright future. Mol Med Report. 2010;3:895-901.

Charuluxananan S, Sumethawattana P, Kosawiboonpol R, Somboonviboon W, Werawataganon T. Efficacy of lubrication of endotracheal tube cuff with chamomile extract for prevention of postoperative sore throat and hoarseness. J Med Assoc Thai. 2004;87(Suppl2):S185-9.

Kyokong O, Charuluxananan S, Muangmingsuk V, Rodanant O, Subornsug K, Punyasang W. Efficacy of chamomile-extract spray for prevention of post-operative sore throat. J Med Assoc Thai. 2002;85(Suppl1):S180-5.

Huang YS, Hung NK, Lee MS, et al. The Efficacy of benzydamine hydrochloride spraying on the endotracheal tube cuff or oral mucosa for postoperative sore throat. Anesth Analg. 2010;111:887-91.

Package leaflet: information for the user. Benzydamine hydrochloride 0.15% w/v oromucosal spray. https://www.hpra.ie/img/uploaded/swedocuments/2202672.PA2158_001_001.0d7e878e-f0b6-4fd4-a57c-99c98737ae7e.000001PIL.180420.pdf

The i-gel ® supraglottic airway-adult sizes [Internet]. [cited 2023 Jan 31]. Available from: https://www.intersurgical.com/content/files/70835/-77387751

The National Drug Development Board, Committee on National Expert in Drug Selection. General anesthetics: sedative and analgesic perioperative drugs. In: The National Drug Development Board, Committee on National Expert in Drug Selection. Thai National Formulary 2015 of Anesthetics and Pain Medication. 2015;P21-4.

Alexopoulos C, Lindholm CE. Airway complaints and laryngeal pathology after intubation with an anatomically shaped endotracheal tube. Acta Anaesthesiol Scand. 1983;27:339-44.

The Filipino Doctor-Doctor information, Health articles, Drug knowledge [Internet]. TheFilipinoDoctor.com. [cited 2023 Mar 31]. Available from: https://thefilipinodoctor.com/drug/kamillosan-m-spray-solution

Taniguchi T, Fujii T, Taniguchi N, Nishiwaki K. Risk factors for postoperative sore throat associated with i-gel™, a supraglottic airway device. Nagoya J Med Sci. 2022;84:319-26.