Anesth Pain Med.  2021 Apr;16(2):163-170. 10.17085/apm.20082.

Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study

• Chung CJ
• Jeong SY
• Jeong JH
• Kim SW
• Lee KH
• Kim JH
• Park SY
• Choi SR

• KMID: 2515542
• DOI: http://doi.org/10.17085/apm.20082

Abstract

Background
Sore throat and hoarseness frequently occur following general anesthesia with tracheal intubation and are effectively reduced when dexamethasone is used prophylactically. Alchemilla vulgaris in glycerine (Neo Mucosal Activator®) suppresses inflammatory response, possibly relieving sore throat.
Methods
We enrolled 94 patients (age ≥ 18 years) scheduled for thoracic surgery using double-lumen tube intubation. Before intubation, 0.2 mg/kg of dexamethasone was administered intravenously and 2 ml of normal saline was sprayed into the oropharyngeal cavity (Group D; n = 45), or 0.04 ml/kg normal saline was administered intravenously and 1 g of Neo Mucosal Activator® mixed with 1 ml of normal saline was sprayed into the oropharyngeal cavity (Group N; n = 43), in a double blind and prospectively randomized manner. Postoperative sore throat and hoarseness were recorded using a numeral rating scale and a 4-point scale to detect a change in voice quality following tracheal extubation (at 1, 6, and 24 h). The primary outcome was the incidence of sore throat at 24 h following surgery. The secondary outcomes were incidence and severity of sore throat and hoarseness.
Results
There were no significant differences in the incidence of sore throat at 24 h following surgery (57.8% vs. 46.5%; P = 0.290) or in the incidence and intensity of sore throat and hoarseness at 1, 6, and 24 h following surgery between the groups.
Conclusions
A. vulgaris in glycerine did not significantly differ from dexamethasone for preventing sore throat and hoarseness owing to intubation.

Keyword

Alchemilla vulgaris; Dexamethasone; Glycerine; Hoarseness; Sore throat

Figure

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  Fig. 1. A 2 ml spray bottle.

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  Fig. 2. CONSORT flow chart for the study patients. Group D: dexamethasone group, Group N: Neo Mucosal Activator group.

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  Fig. 3. Incidence of sore throat at follow-up (1, 6, and 24 h). Group D: dexamethasone group, Group N: Neo Mucosal Activator group.

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  Fig. 4. Incidence of hoarseness at follow-up (1, 6, and 24 h). Group D: dexamethasone, Group N: Neo Mucosal Activator group.

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  Fig. 5. Intensity of sore throat at follow-up (1, 6, and 24 h). Values are presented as mean ± SD. Group D: dexamethasone, Group N: Neo Mucosal Activator group, NRS: numeric rating scale. *P value was obtained by repeated measure ANOVA.

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