Combined effect of Intravenous Lidocaine and Dexamethasone on Postoperative Sore Throat, Cough and Hoarseness: A Randomized Controlled Trial

Background: Postoperative sore throat, hoarseness and cough following tracheal intubation are not uncommon. Although, prophylactic use of both lidocaine and dexamethasone has been used independently to reduce these events, there is no study assessing the combined effects of lidocaine and dexamethasone.

Objective: To compare the effect of dexamethasone and lidocaine combination on incidence and severity of sore throat, hoarseness and cough with either treatment alone.

Methods: In this prospective, double- blind, randomized controlled study, a total of 180 patients requiring GA with endotracheal intubation for more than 90 min were enrolled. They received one of the four assigned study medications intravenously prior to induction of anesthesia: Group L, lidocaine 1.5 mg/kg; Group D, dexamethasone 8 mg; Group LD, lidocaine 1.5 mg/kg with dexamethasone 8 mg; and Group NS, normal saline. Standard anesthesia protocol was followed. Incidence and severity of sore throat during rest and while swallowing, cough and hoarseness of voice were assessed at 1-2 h, 6 h, 12 h and 24 h postoperatively.

Results: Data of 45 patients in D, 44 in L, 44 in LD and 43 in NS group were analyzed. Incidence of sore throat was 17(23%), 19(28%), 11(16%) and 23(33%) in group D, L, LD and NS respectively (p=0.04). No difference was observed in severity of sore throat, incidence and severity of cough and hoarseness between the groups.

Conclusion: Combination of dexamethasone and lidocaine reduced the incidence of postoperative sore throat in patients requiring prolonged tracheal intubation for general anesthesia.

Trial registration: clinicaltrial.gov- NCT01990781