Effect of preoperative tramadol gargle on postoperative sore throat in middle ear surgeries under general anaesthesia with endotracheal intubation

This study is designed to study the effect of preoperative Tramadol gargle on postoperative sore throat in patients scheduled for elective middle ear surgeries under general anaesthesia with oral endotracheal intubation. Post-operative sore throat (POAT) is rated to be the 8th most undesirable outcome in the postoperative periodwith an incidence ranging from 14.4-50% after tracheal intubation and 5.8-34% after laryngeal mask airway insertion. The etiology of sore throat is thought to involve mucosal dehydration, trauma from instrumentation and intubation, and mucosal erosion caused by endotracheal tube cuff. Potential risk reduction interventions for POST include smaller sized tube size, limiting intra-cuff pressure, video laryngoscopy, gentle airway instrumentation, extubation after full deflation of cuff, benzydamine hydrochloride, aspirin (NSAIDs), ketamine, magnesium sulphate (NMDA receptor antagonists) and tramadol. Tramadol is a centrally acting analgesic with μ receptor affinity, which inhibits norepinephrine and 5-hydroxytryptamine re-uptake with modulatory effects on voltage gated sodium ion channels, thus exerting a local anaesthetic effect. Tramadol is shown to reduce pain on peritonsillar injection, topical use over tonsillar fossa and to attenuate sore throat when used in gargle form.