A Comparative Study of Three Nebulized Medications for the Prevention of Postoperative Sore Throat in the Pediatric Population

The delivery of aerosolized drugs is a vital component of treatment for many respiratory disorders. We used this mode of medication delivery as a pre-emptive strategy to alleviate a Postoperative Sore Throat (POST) in children receiving general anesthesia.

The primary aim of the study was to compare the effects of prophylactic ketamine, magnesium sulfate and dexamethasone nebulization, on the intensity of POST.

Through a prospective, randomized, double-blind study, data were collected from children (6-16 years) undergoing surgeries from March 2018 to May 2018. The patients were allocated into 3 equivalent groups (36 patients each). Preoperative nebulization was performed for all patients. Group M received 40 mg/kg magnesium sulphate, group K received 1 mg/kg ketamine, and group D received 0.16 mg dexamethasone. The primary outcome of the study was the incidence and intensity of POST at the 4^th postoperative hour. The secondary outcomes included evaluation of adverse effects specifically nausea, vomiting, postoperative cough and postoperative sedation.

Patients in the K group had the lowest incidence of POST compared to patients in groups M and D, specifically, at the 4^th - postoperative hour (p-value = 0.003).

Preoperative nebulization with ketamine was more effective in reducing the intensity of POST in pediatric patients postoperatively without systemic adverse effects.