Background:
The postoperative sore throat (POST) and post-extubation cough (PEC) frequently follow the insertion of an endotracheal tube in general anesthesia, which makes postoperative morbidity higher. We aimed to assess the efficacy of the dexmedetomidine-soaked pharyngeal pack in alleviating POST versus Ketamine among patients with functional endoscopic sinus surgery (FESS).
Methods:
One hundred twenty patients were randomized into three groups, each containing 40 patients. Following anesthesia induction and intubation, the placement of pharyngeal packs in either saline (group C), Ketamine (group K), or dexmedetomidine (group D) in the posterior pharyngeal wall was done under clear vision. The primary outcome was the incidence of POST at six hours following surgery. The secondary outcomes were the incidence of POST at 0, 12, and 24 hours, at 0, 30, 60, 90, and 120 minutes, and the Postoperative Nausea and Vomiting (PONV) score at 1, 2, and 6 hours.
Results:
None of the patients of Group D experienced a POST at 6 hours post-operatively, and this was significantly lower when compared to the ketamine group (67.5%) and control group (87.5%) with a p-value (<0.001). At 6 hours post-operatively, group K experienced considerably fewer POST episodes than group C. Group D showed a lower cough incidence than other groups at 60 minutes. PONV was significantly higher in group K at 2 hours post-operatively.
Conclusions:
Pharyngeal-soaked dexmedetomidine effectively prevented postoperative airway complications, especially POST, in patients after the FESS procedure.