Application of triamcinolone acetonide paste to the endotracheal tube reduces postoperative sore throat: a randomized controlled trial

Can J Anaesth. 2011 May;58(5):436-42. doi: 10.1007/s12630-011-9478-6. Epub 2011 Feb 26.

Abstract

Purpose: This study was performed to examine whether applying triamcinolone acetonide paste as a lubricant to endotracheal tubes (ETTs) reduces the incidence and severity of postoperative sore throat (POST) more effectively than applying chlorhexidine gluconate jelly.

Methods: This was a randomized controlled clinical trial. Patients enrolled in the study were ages 20 to 70 yr, American Society of Anesthesiologists' physical status I and II, and scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups, the chlorhexidine group and the triamcinolone group. Prior to endotracheal intubation, ETTs in the chlorhexidine group were lubricated with 0.1% chlorhexidine gluconate jelly, whereas the ETTs in the triamcinolone group were lubricated with 0.1% triamcinolone acetonide paste 0.5 mg. During the 24 hr after the operation, we recorded the incidence and severity of POST and the incidence of cough, hoarseness, dysphagia, nausea, and dry throat.

Results: Of the 150 patients initially enrolled, 143 patients were included in the study. The incidence of POST was significantly lower in the triamcinolone group compared with the chlorhexidine group (difference = 52.4%; 95% confidence interval, 36.8% to 64.2%; P < 0.001). The severity score for the triamcinolone group was significantly lower than that for the chlorhexidine group. The frequencies of coughing, hoarseness, dysphagia, nausea, and dry throat were similar in the two groups for the first 24 hr after surgery.

Conclusions: Triamcinolone acetonide paste applied along the length of the ETT resulted in clinically important and statistically significant decreases in the incidence and severity of POST compared with the application of chlorhexidine jelly. (ClinicalTrials.gov number, NCT00908817).

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Chlorhexidine / administration & dosage
  • Chlorhexidine / analogs & derivatives
  • Chlorhexidine / therapeutic use
  • Cholecystectomy, Laparoscopic / methods
  • Double-Blind Method
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Incidence
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / methods*
  • Male
  • Middle Aged
  • Pharyngitis / epidemiology
  • Pharyngitis / etiology
  • Pharyngitis / prevention & control*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Severity of Illness Index
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / therapeutic use*
  • Young Adult

Substances

  • Glucocorticoids
  • Triamcinolone Acetonide
  • chlorhexidine gluconate
  • Chlorhexidine

Associated data

  • ClinicalTrials.gov/NCT00908817