Postoperative sore throat: inevitable side effect or preventable nuisance?

Excerpt

In this issue of the Journal, Kuriyama et al.1 present a well-conducted systematic review and meta-analysis showing that topical magnesium is highly effective in preventing postoperative sore throat (POST) after endotracheal intubation. Although POST is often considered a minor complication of anesthesia, it remains one of the most common patient complaints after general anesthesia with an incidence of 20–40%.2,3 Furthermore, anesthesiologists may not be aware of the incidence of sore throat in their own practice, as many patients may not seek medical advice for POST. In a large (n = 12,276) prospective cohort study of a broad cross section of surgical patients, 20% of patients complained of sore throat after general anesthesia, second only to postoperative nausea and vomiting.2 Female gender and younger age were identified as risk factors. Another large (n = 809) prospective study identified a higher incidence of 40% as well as identifying additional independent risk factors, including a history of smoking or lung disease, longer duration of anesthesia, postoperative nausea, natural teeth (vs dentures), and blood visible on the endotracheal tube at extubation.3 Still, other risk factors for POST have been identified including various intubation techniques4 and the use of larger diameter double lumen endotracheal tubes.5 Fortunately, POST appears short-lived with most cases resolving within 48 hr of anesthesia.3

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