- Direct trauma from airway insertion e.g. ETT, SAD, OPA or NG tube
- Direct pressure effect on airway structures e.g. from ETT cuff
- Dry mouth/throat e.g. from non-humidified anaesthetic gases, effect of drugs (glycopyrrolate, atropine)
Sore Throat
Sore Throat
Resources
- This is perhaps the most common adverse effect of general anaesthesia
- The incidence ranges from 5-20% (Guedel airway) to 20-35% (with SAD) to 40-50% (with ETT) and is overall described as 'very common' by the RCoA
| Airway device factors | Other factors |
| Larger diameter ETT | Use of NG tubes |
| Traumatic/difficult ETT insertion | Long duration of surgery |
| High ETT cuff inflation pressures | Non-humidified gases |
| Female gender | |
| Younger age |
Prevention
- Prevention is largely by addressing the risk factors above, where possible
- Topicalising the vocal cords with 10% lidocaine appeared to cause a non-statistically-significant reduction in sore throat
- Use of 1% hydrocortisone gel increased the incidence of a sore throat
- Some chaps in India found that gargling ketamine pre-induction reduces the incidence of sore throat by approximately 50%
Management
- Primarily reassurance, as it spontaneously resolves within 48 - 72hrs
- Simple analgesics i.e. paracetamol, NSAID can help
- Gargling the NSAID benzydamine hydrochloride (a.k.a Difflam) can help reduce the symptoms
- Patients should see their GP or ED if the experience:
- Dyspnoea
- Haemoptysis
- Persistent change in voice