Sore throat and nausea
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Sore Throat and Nausea: Postoperative Complications and Management Strategies
Introduction to Postoperative Sore Throat and Nausea
Postoperative sore throat (POST) and nausea are common complications following surgeries, particularly those involving general anesthesia and endotracheal intubation. These symptoms can significantly affect patient comfort and recovery. Understanding the incidence, associated factors, and potential management strategies is crucial for improving postoperative care.
Incidence and Factors Associated with Postoperative Sore Throat
General Anesthesia and Tracheal Intubation
Sore throat is a frequent complaint after tracheal intubation for general anesthesia, with an incidence rate of approximately 40% . Factors such as female sex, history of smoking or lung disease, duration of anesthesia, and presence of bloodstains on the endotracheal tube are significantly associated with increased incidence and severity of sore throat .
Supraglottic Airway Devices
The use of supraglottic airway devices (SADs) like the laryngeal mask airway (LMA) and I-gel has been explored as alternatives to traditional tracheal intubation. Studies indicate no significant difference in the incidence of sore throat among different SADs, although some devices may cause higher rates of dysphagia .
Management Strategies for Postoperative Sore Throat
Kampo Medicines
Kampo medicines, such as Hange-Shashin-To (HST) and Kikyo-To (KKT), have shown efficacy in reducing the incidence and severity of postoperative sore throat. In randomized controlled trials, both HST and KKT significantly decreased sore throat symptoms immediately and three hours post-surgery compared to placebo, although they did not significantly affect postoperative nausea Kuwamura2015Kuwamura2016.
Zinc-Impregnated Pharyngeal Packs
The use of zinc-impregnated pharyngeal packs during surgeries like septorhinoplasty has been investigated. However, studies found no significant reduction in sore throat incidence or severity with zinc packs compared to conventional methods .
Saline-Soaked Pharyngeal Packing
Intraoperative saline-soaked pharyngeal packing has been associated with a higher incidence of sore throat immediately and 24 hours post-surgery, without significantly reducing postoperative nausea and vomiting . Similarly, other studies have shown that pharyngeal packs do not prevent nausea and vomiting and may worsen sore throat and dysphagia Faro2020Karbasforushan2014.
Electroacupuncture
Electroacupuncture (EA) has been shown to significantly reduce the incidence and severity of both postoperative sore throat and nausea. Patients receiving EA had lower visual analogue scale (VAS) scores for sore throat and fewer episodes of nausea and vomiting compared to control groups .
Dexamethasone
A single dose of dexamethasone administered intravenously has been effective in reducing the incidence and severity of postoperative sore throat, nausea, and vomiting in patients undergoing surgeries like caesarean sections under general anesthesia .
Conclusion
Postoperative sore throat and nausea are prevalent issues that can impact patient recovery and satisfaction. Various strategies, including the use of Kampo medicines, electroacupuncture, and dexamethasone, have shown promise in managing these symptoms. However, methods like zinc-impregnated and saline-soaked pharyngeal packs have not demonstrated significant benefits and may even exacerbate sore throat. Tailoring postoperative care to include effective management strategies can enhance patient outcomes and comfort.
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