Reducing Postoperative Sore Throat by using Topical Anesthetic Cream

Postoperative sore throat (POST) is a common complaint among patients undergoing general anesthesia with endotracheal intubation. It is characterized by pain, discomfort, or irritation in the throat, ranging from mild to severe. POST typically develops within the first 24 hours after surgery and may be accompanied by other symptoms such as coughing, hoarseness, and difficulty swallowing. The endotracheal tube (ETT) used during anesthesia can cause irritation, inflammation, and damage to the lining of the throat. POST can be distressing for patients and may require treatment with pain relievers or other medications to manage the symptoms.

In a study, researchers investigated whether applying a topical anesthetic cream to the ETT cuff can significantly reduce the incidence and severity of POST, cough, and hoarseness of voice in adults after surgery. The study, which was randomized and placebo-controlled, involved 204 adult patients between the ages of 18 and 65 who were scheduled to receive either a 5% eutectic mixture of local anesthetic (EMLA, lidocaine, and prilocaine) cream (intervention group) or a lubricant gel (placebo group) applied over the ETT cuff.

The study's primary outcome was the incidence of POST at the sixth postoperative hour. Secondary outcomes included the incidence of POST at 0, second, and 24 hours and the incidence and severity of postoperative cough and hoarseness of voice.

The study found that the incidence of POST was significantly lower in the EMLA group compared to the placebo group at the sixth postoperative hour (4.9% vs. 40.1%) and at 0 and second hours (74.5% vs. 93.1%; 51.9% vs. 84.3%). However, there was no significant difference between the two groups at 24 hours. The proportion of patients with severe POST over 24 hours was also significantly lower in the EMLA group (9.8% vs. 43.1%).

In addition, the study found that the incidence of postoperative cough and hoarseness of voice was significantly lower in the EMLA group at 0, second, and sixth hours but not at 24 hours. The incidence of severe cough (8.8% vs. 31.4%) and hoarseness of voice (2% vs. 7.4%) over 24 hours was also lower in the EMLA group.

The researchers concluded that applying EMLA cream over the ETT cuff can effectively reduce the incidence and severity of POST, cough, and hoarseness of voice in the early postoperative period compared to lubricant gel. This finding may have important implications for improving patient comfort and reducing postoperative complications.
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