As Anesthetists, we are known as airway experts. Both Surgeons and patients trust our skills at maintaining an open airway to ensure patient safety. At the end of the case, we wake our patients and take them to recovery with an open airway and then move on to the next patient. In the midst of production pressure we lose sight of the minor things that cause discomfort to our patients. Postoperative sore throat is an example.
Studies that assess patient concerns for surgery have found postoperative sore throat to be one of the top 10 concerns. The reported incidence varies but several studies find it to be around 40%. The problem is usually most severe in the first 6 hours after surgery and is common enough that many feel it is a natural consequence of general anesthesia.
In a study by Jaensson, Gupta, and Nilsson published in the August 2012 AANA Journal research edition, (Risk Factors for Development of Postoperative Sore Throat and Hoarsness After Endotracheal intubation in Women: A Secondary Analysis) the authors gathered data to determine risk factors for development of postoperative sore throat. Both patient demographic data and airway management techniques were reviewed.
The authors found that general anesthesia with endotracheal intubation can cause minor sore throat which is more common in the female population. In most cases, symptoms are minor and resolve spontaneously, however in some cases sever sore throat can cause prolonged discomfort to the patient. The authors found 3 risk factors for development of sore throat in women:
- Age greater than 60
- Use of a throat pack
- Endotracheal tube size (#7 significantly more sore throats than #6)
The authors speculated that higher mallampati scores, therefore more difficult intubations, would increase the incidence of sore throat but that was not found to be true in this study. The authors were surprised to find that cuff pressures below 20 were associated with an increased incidence of hoarsness.
The authors noted that the reason for the higher incidence of sore throat in women is unclear and requires further study.
Click here to read the original article published in the AANA Journal
My expeience is that the more things we put in the patient’s mouth, the greater the incidence of sore throat. The unnecessary NG tube is an example. When we put one in “just because” we increase the likelihood of post op sore throat.