Nebulized Dexamethasone versus Intravenous Dexamethasone in Prevention of Postoperative Sore Throat: An Interventional Study.

Abstract

Context: This study investigated the effects of preoperative dexamethasone, administered intravenously or through nebulization, on postoperative sore throat (POST) and glucose regulation in patients undergoing general anesthesia (GA) with endotracheal intubation.

Aims: This study aimed to asses the effectiveness of nebulised versus intravenous dexamethasone in prevention of postoperative sorethroat in patients undergoing GA with endotracheal intubation.

Settings and design: This study was a prospective, single-blind, randomized controlled trial with a sample size of 138 participants.

Subjects and methods: A total of 144 patients were randomized into three groups (48 each): Group A (control), Group B (nebulized dexamethasone), and Group C (intravenous dexamethasone). Baseline characteristics, including age, gender, and ASA classification, were similar across groups. POST was assessed at multiple time points postoperation, whereas modified Cormack-Lehane grading and intubation attempts were recorded intraoperatively. Blood glucose (general random blood sugar [GRBS]) levels were measured pre- and postoperatively to assess the effect of dexamethasone.

Statistical analysis used: Statistical analysis was performed using SPSS (Statistical Package for the Social Sciences) version 21 (IBM SPSS Statistics, IBM Corporation, NY, USA).

Results: The gender distribution differed significantly across groups (P = 0.04), whereas other demographic factors were comparable. Group B reported the lowest incidence of POST across all time points, with significant reductions compared to Groups A and C (P = 0.001). Cormack-Lehane Grade 1 laryngeal view rates were similar across groups (P = 0.76), with no significant differences in intubation attempt numbers (P = 0.76). Postoperative GRBS was significantly higher in Group C than in Group B (P = 0.001), indicating increased glucose levels with intravenous dexamethasone.

Conclusions: Preoperative nebulized dexamethasone effectively reduced POST incidence with minimal impact on postoperative glucose levels, whereas intravenous administration was associated with higher glucose levels. Nebulized dexamethasone may be a preferable option for sore throat prevention in patients undergoing GA with endotracheal intubation, balancing efficacy and metabolic impact. Further studies are recommended to confirm these findings.