Postoperative laringo-pharyngeal symptoms in elective surgery - Incidence and related factors

Introduction: To determine cumulative incidence of sore throat complaints (STCs) which occur with the insertion of the laryngeal mask (LM) and endotracheal tube (ETT) during the first hour and 24 hours after elective surgery. In addition, to establish risk factors associated with its occurrence. Methods: In a cohort study, a total of 451 patients scheduled for elective non-cardiac surgery were included consecutively for 6 months (ASA I-II-III, >18 years old) who underwent LM or ETT airway management for general anesthesia. Through a questionnaire with indirect and direct questions the presence of sore throat, hoarseness, dysphagia and the composite endpoint STCs were assessed one and 24 hours after surgery. Marginal models were used to identify risk factors. Results: We found an incidence of STCs of 26.8% and 13.5% at first and 24 postoperative hours respectively. At first hour, they were classified as sore throat (23.9%), hoarseness (6.7%) and dysphagia (6.4%). Each compound was not mutually exclusive. At 24 hours of follow up, incidence of STCs and its compounds decreases significantly but differently to ETT and LM. STCs were associated with female gender (OR=1.53 95%CI 1.00-2.37, p=0.05), ETT intubation (OR=4.20 95%CI 2.19-8.04, p<0.01) and bloodstain on airway device at extubation (OR=2.00 95%CI 1.18-3.36, p<0.01). Conclusions: The incidence of STCs remains important. There are differences in the pattern of reduction between ETT and LM over time and this study confirms risk factors for postoperative STCs like use of ETT, presence of blood during the airway device extraction and female gender.

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