Postoperative Sore Throat Following General Surgical Procedures under General Anesthesia with Endotracheal Intubation

Abstract

Background: Postoperative sore throat (POST) is a frequent complication following general anesthesia with tracheal intubation, significantly impacting patient comfort and satisfaction. Despite being considered a minor issue by healthcare providers, POST remains a substantial concern for patients. The incidence of POST varies widely among different studies, necessitating further investigation into its prevalence and contributing factors.

Objective: To evaluate the prevalence of postoperative sore throat among patients undergoing elective and general surgeries requiring tracheal intubation under general anesthesia at two teaching hospitals in KPK, Pakistan, and to identify factors associated with its occurrence.

Methods: A descriptive cross-sectional study was conducted from July to December 2023 at Mardan Medical Complex, Mardan, and Northwest General Hospital and Research Center, Peshawar. A total of 295 patients aged 18-65 years, with ASA physical status I or II, undergoing elective and general surgeries with tracheal intubation, were included using a convenience sampling technique. Exclusion criteria included unwilling participants, those with preoperative sore throat, emergency surgeries, and ASA physical status III or IV. Data were collected on patient demographics, surgical details, and postoperative symptoms. Patients were interviewed 1 to 2 hours post-surgery about symptoms such as throat pain, dysphagia, thirst, and hoarseness. The data were analyzed using SPSS version 25, and frequencies and percentages were computed for categorical variables. The study adhered to ethical standards in line with the Declaration of Helsinki.

Results: Out of 295 patients, 115 (38.9%) experienced postoperative sore throat. Among males, 30.5% (41/134) reported POST, whereas 45.9% (74/161) of females were affected. Age-wise, 22.3% (44/197) of patients aged 18-30 years reported POST, compared to 85.0% (23/27) aged 31-40 years, 75.5% (34/45) aged 41-55 years, and 53.8% (14/26) aged over 56 years. The incidence of POST was higher with larger ETT sizes: 13.9% (9/65) for size 6.0, 29.9% (29/97) for size 6.5, 61.5% (24/39) for size 7.0, and 63.6% (42/66) for size 7.5. Only 3.5% (1/28) of patients using LMA reported POST. Surgical procedure duration also influenced POST incidence: 33.9% (18/53) for incision and drainage, 37.0% (33/89) for appendectomy, 44.6% (21/47) for laparotomy, 35.4% (11/31) for hernia repair, and 42.6% (32/75) for other surgeries.

Conclusion: The study identified a 38.9% incidence of postoperative sore throat among patients undergoing surgeries with tracheal intubation under general anesthesia. Factors such as gender, age, ETT size, and type of surgical procedure significantly influenced the occurrence of POST. Awareness and specific guidelines are essential to manage and reduce the incidence of POST, thereby improving patient outcomes and satisfaction.