Authors: Sousa Braga I et al.
Source: Cureus 17(12): e98473. DOI: 10.7759/cureus.98473
Summary:
This retrospective study evaluated postoperative sore throat (POST) in 106 adults recovering in the PACU after general anesthesia with airway instrumentation. The overall incidence of POST was 21.7%, which is lower than the 30–60% commonly reported in prior literature. Moderate symptoms (VAS 4–7) occurred in only 5% of patients, all of whom had endotracheal intubation.
Mechanical airway factors were the strongest contributors to symptom development. Difficult laryngoscopy significantly increased both the incidence and severity of POST, and multiple intubation attempts were also strongly associated with worse symptoms. In contrast, pharmacologic interventions—including dexamethasone, lidocaine, ketamine, NSAIDs, magnesium, and others—did not reduce the likelihood of POST in this cohort. Use of videolaryngoscopy, stylets, or supraglottic airway devices also did not demonstrate meaningful protective effects.
The findings emphasize that atraumatic airway management, particularly first-pass success and minimizing manipulation, remains the most effective strategy for reducing postoperative sore throat. Drug-based prophylaxis remains inconsistent and should be viewed only as an adjunct rather than a primary preventive measure.
What You Should Know:
• POST occurred in 21.7% of patients; only 5% had moderate symptoms.
• All moderate cases followed endotracheal intubation.
• Difficult laryngoscopy and repeated attempts were the strongest predictors.
• No pharmacologic agent showed meaningful protection against POST.
• Optimizing intubation technique is the most reliable prevention strategy.
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