Efficacy of Benzydamine Hydrochloride in Reducing Postoperative Sore Throat after General Anesthesia with Endotracheal Tube: a Randomized Controlled Trial

Abstract

Background: Postoperative sore throat (POST) is a common complication following general anesthesia with endotracheal intubation and adversely affects patient satisfaction. Benzydamine hydrochloride (BH), a topical nonsteroidal anti-inflammatory drug, has been proposed to prevent POST; however, evidence regarding its efficacy and optimal application remains inconsistent. This study is to evaluate the efficacy of benzydamine hydrochloride spray applied to the endotracheal tube (ETT) cuff alone or in combination with oropharyngeal administration in reducing postoperative sore throat. Methods: This randomized, double-blind, controlled trial enrolled adult patients undergoing elective surgery under general anesthesia with endotracheal intubation. Participants were randomized into three groups: group A received BH spray applied to both the ETT cuff and the oropharynx; group B received BH spray applied to the ETT cuff and placebo spray applied to the oropharynx; and group C received placebo spray applied to both sites. Endotracheal tube cuff pressure was maintained below 25 cmH2O. The incidence and severity of POST and hoarseness were assessed at 1, 6, and 24 h postoperatively. Results: A total of 156 patients completed the study. The overall incidence of POST was 46.2%, with no significant differences among group A (48.1%), group B (50.0%), and group C (40.0%). POST severity scores were low and comparable among groups at all time points. No significant differences were observed in hoarseness, other throat-related symptoms, or adverse effects. Conclusion: Under appropriate ETT size selection and strict cuff pressure control, 0.3% benzydamine hydrochloride spray did not reduce the incidence or severity of postoperative sore throat.