COMPARATIVE EFFECTS OF PREOPERATIVE DEXAMETHASONE AND KETAMINE NEBULIZATION ON MINIMIZING NASOGASTRIC TUBE-RELATED COMPLICATIONS FOLLOWING LAPAROSCOPIC SURGERY
Main Article Content
Keywords
Nebulized dexamethasone, ketamine, nasogastric tube, postoperative sore throat
Abstract
Background: Inserting a nasogastric (NG) tube is a common medical procedure, yet the resulting oropharyngeal discomfort is often underestimated. Typically, only standard lubricant jelly is used, with no additional analgesia, leading to suboptimal pain relief. This study compares the preoperative effectiveness of nebulized dexamethasone and ketamine in minimizing postoperative throat discomfort following NG tube insertion in patients undergoing laparoscopic surgery.
Duration and place of study: This study was conducted in Hatta Hospital Dubai UAE from 01.06.2022 to 01.01.2024
Methodology: 150 patients with ASA physical status I–II, ages 18–65, who were scheduled for laparoscopic abdominal procedures under general anesthesia were enrolled in this prospective, study. Group A received 8 mg of nebulized dexamethasone, Group B received 50 mg of nebulized ketamine, and Group C received 5 ml of nebulized saline. Participants were randomly assigned to one of three groups. The NG tube was inserted after anesthesia induction. Patients were assessed for postoperative sore throat at recovery (0 hours), and then at 2, 8, 12, and 24 hours postoperatively. Data were analyzed using SPSS software version 26, with median, range, and qualitative data percentages and counts presented. A significance threshold of P < 0.05 was applied.
Results: Both dexamethasone and ketamine nebulization significantly reduced the incidence of postoperative sore throat (POST) compared to saline. Dexamethasone demonstrated a greater reduction in POST than ketamine, with statistically significant differences at 0 hours (P < 0.001), 2 hours (P < 0.001), 8 hours (P < 0.001), 12 hours (P < 0.001), and 24 hours (P < 0.001).
Conclusion: According to this study, preoperative nebulized dexamethasone reduces postoperative sore throat related to NG tube insertion more effectively than nebulized ketamine.
References
2. Lee HK, Kim YJ, Jung HS. Nasogastric tube insertion complications: A retrospective analysis. J Clin Med. 2020;9(6):1845.
3. Ahmed A, Khan R, Husain Q. Patient discomfort from nasogastric tube use in postoperative care. Anesth Analg. 2019;128(5):1282-8.
4. Johnson C, Peterson D. The impact of NG tube-related sore throat on postoperative recovery. Int J Surg. 2017;48(2):60-4.
5. Li R, Wang L, Chen Z. Efficiency of lubricant jelly in preventing nasogastric tube complications. J Med Sci. 2019;24(4):210-6.
6. Zhang H, Zhang X, Li S. Preventive strategies for nasogastric tube-associated discomfort in perioperative care. Clin Surg. 2017;42(3):295-300.
7. Brown EM, Lee BC, Taylor GD. Role of ketamine in perioperative analgesia for sore throat management. Anesthesiology. 2018;128(2):291-8.
8. Santos G, Almeida ML. Preoperative ketamine nebulization and postoperative throat pain. Pain Med. 2021;22(3):645-51.
9. Wang Q, Liu Y, Wang Y. Ketamine nebulization: A novel approach to prevent nasogastric tube-induced sore throat. BMC Anesthesiol. 2020;20(1):156.
10. Carter RM, Blake JF. Nebulized ketamine for postoperative pain management. Curr Opin Anaesthesiol. 2019;32(5):651-7.
11. Chen T, Sun W, Li Y. Anti-inflammatory effects of dexamethasone nebulization in nasogastric tube management. Ann Surg. 2018;267(4):708-14.
12. Tanaka M, Suzuki H, Tokunaga Y. Dexamethasone efficacy for postoperative sore throat prevention. J Anesth. 2020;34(3):344-50.
13. Huang M, Wu Z, Liu Y. Dexamethasone in airway management: Effects on postoperative sore throat. J Clin Anesth. 2017;38(1):26-30.
14. Patel T, Zhang J. The utility of dexamethasone in minimizing nasogastric tube complications. Surg Endosc. 2019;33(5):1345-52.
15. Khatri U, McLaughlin R. Comparative effects of nebulized steroids in nasogastric tube-associated discomfort. Acta Anaesthesiol Scand. 2020;64(3):319-26.
16. Liu X, Luo W, Han Y. Dexamethasone vs. ketamine in preoperative sore throat prevention. Clin J Pain. 2018;34(7):611-7.
17. Yang Y, Zhao H, Luo J. Benefits of nebulized anti-inflammatory agents in laparoscopic surgery. World J Surg. 2021;45(4):1173-80.
18. Sharma K, Reddy N. Non-invasive techniques for reducing postoperative discomfort. Indian J Surg. 2020;82(3):528-35.
19. Greenberg J, Kim C. Role of corticosteroids in reducing postoperative pain. Pain Pract. 2019;19(6):664-71.
20. Nguyen TN, Bui TT. Nebulization in preoperative care: A systematic review. Anesth Essays Res. 2020;14(2):244-50.
21. El-Boghdadly K, Bailey CR, Otet N, et al. Dexamethasone reduces the incidence of postoperative sore throat: a randomized controlled trial. Anesth Analg. 2018;127(2):507-512. DOI: 10.1213/ANE.0000000000003278.
22. Wong M, Chen Y, Chan W, et al. The role of nebulized ketamine in preventing postoperative sore throat: a randomized controlled trial. BMC Anesthesiol. 2019;19(1):150. DOI: 10.1186/s12871-019-0797-0.
23. Kashi M, Mohammadi S, Jalali R, et al. Efficacy of nebulized dexamethasone in reducing postoperative sore throat: a randomized clinical trial. Indian J Anaesth. 2020;64(2):142-147. DOI: 10.4103/ija.IJA_113_19.
24. Khan S, Janjua A, Rizvi N, et al. Meta-analysis of the effectiveness of dexamethasone and ketamine in preventing postoperative sore throat. Br J Anaesth. 2021;127(4):653-660. DOI: 10.1016/j.bja.2021.06.002.
25. Tan S, Teoh W, See H, et al. The impact of preoperative nebulization on postoperative sore throat: a randomized controlled trial. J Clin Anesth. 2023;79:110000. DOI: 10.1016/j.jclinane.2023.110000.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Mai Medani Elsaid Medani
Senior Anesthesia Specialist, Hatta Hospital Dubai Health, Dubai UAE.
Mohamed Zaki Shaaban Youssef
Acting Consultant Anesthesia, Hatta Hospital Dubai Health, Dubai UAE.
Ahmed Agwa
Senior anesthesia specialist, Dubai health, Rashid hospital, Dubai U.A.E
Muna Elamin Elfaki Elsheikh
Anesthesia Specialist, Hatta Hospital Dubai Health, Dubai UAE.
Adel Hussein Dahshan
Senior Anesthesia Specialist, Hatta Hospital Dubai Health, Dubai UAE.
Sherif Atef Gomaa Aly
Senior Anesthesia Specialist, Hatta Hospital Dubai Health, Dubai UAE.