Effects of preoperative inhaled budesonide combined with intravenous dexamethasone on postoperative sore throat in patients who underwent thyroidectomy: A randomized controlled trial

Medicine (Baltimore). 2024 May 17;103(20):e38235. doi: 10.1097/MD.0000000000038235.

Abstract

Background: This randomized controlled trial aimed to evaluate the efficacy of preoperative inhaled budesonide combined with intravenous dexamethasone on postoperative sore throat (POST) after general anesthesia in patients who underwent thyroidectomy.

Methods: Patients who underwent elective thyroidectomy were randomly divided into the intravenous dexamethasone group (group A) and budesonide inhalation combined with intravenous dexamethasone group (group B). All patients underwent general anesthesia. The incidence and severity of POST, hoarseness, and cough at 1, 6, 12, and 24 hours after surgery were evaluated and compared between the 2 groups.

Results: There were 48 and 49 patients in groups A and B, respectively. The incidence of POST was significantly lower at 6, 12, and 24 hours in group B than that in group A (P < .05). In addition, group B had a significantly lower incidence of coughing at 24 hours (P = .047). Compared with group A, the severity of POST was significantly lower at 6 (P = .027), 12 (P = .004), and 24 (P = .005) hours at rest, and at 6 (P = .002), 12 (P = .038), and 24 (P = .015) hours during swallowing in group B. The incidence and severity of hoarseness were comparable at each time-point between the 2 groups (P > .05).

Conclusion: Preoperative inhaled budesonide combined with intravenous dexamethasone reduced the incidence and severity of POST at 6, 12, and 24 hours after extubation compared with intravenous dexamethasone alone in patients who underwent thyroidectomy. Additionally, this combination decreased the incidence of postoperative coughing at 24 hours.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Administration, Intravenous
  • Adult
  • Anesthesia, General / adverse effects
  • Anesthesia, General / methods
  • Budesonide* / administration & dosage
  • Dexamethasone* / administration & dosage
  • Dexamethasone* / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / administration & dosage
  • Hoarseness / epidemiology
  • Hoarseness / etiology
  • Hoarseness / prevention & control
  • Humans
  • Male
  • Middle Aged
  • Pharyngitis* / epidemiology
  • Pharyngitis* / etiology
  • Pharyngitis* / prevention & control
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / prevention & control
  • Preoperative Care* / methods
  • Thyroidectomy* / adverse effects
  • Treatment Outcome