Comparison of the efficacy of intravenous dexamethasone, betamethasone gel and lignocaine jelly in reducing postoperative sore throat among prone-positioned patients

• Author Details:   
• Bismi R
• Greeshma N Murdeshwar ^*

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Background and Objectives: Post-operative sore throat (POST), post extubation cough (PEC) and hoarseness of voice (HOV) are common post operative complications causing patient dissatisfaction and morbidity. The etiology of POST is multifactorial that includes patient positioning, as shifting from supine to prone cause displacement of the endotracheal tube (ETT). This study aimed to compare the efficacy to reduce POST, PEC and HOV between intravenous dexamethasone, betamethasone gel and lignocaine jelly among prone positioned patients.

Methodology: Ninety patients aged between 18-60 years, American society of anaesthesiologists (ASA) class I and II undergoing elective spine surgeries in prone position under general anaesthesia were randomly assigned into three groups of 30 each. ETT was lubricated with 0.05% betamethasone gel in Group-B, 2% lignocaine jelly in Group-L and intravenously 0.2mg/kg dexamethasone was given in Group-D. The occurrence of postoperative sore throat, post-extubation cough, and hoarseness of voice was evaluated at 1, 6, 12, and 24 hours after surgery.

Results: Among Group B, D and L the incidence of POST was 0%, 26.7% and 50% at 12 hours respectively and 0%, 20% and 60% at 24 hours respectively. Betamethasone had statistically significant lowest POST incidence (B vs D, p=0.01 at 12 hours; 0.03 at 24 hours; B vs L, p<0 p=0.002).>

Conclusion: Betamethasone gel effectively reduces POST, PEC, and HOV in patients undergoing prone positioning during surgery when compared to intravenous dexamethasone and lignocaine jelly.

Keywords: Betamethasone; Lignocaine; Dexamethasone; Post operative sore throat; Post extubation cough; Hoarseness of voice.