A Randomised Clinical Trial Comparing the Impacts of Magnesium Sulphate and Ketamine Spray on the Incidence and Severity of Sore Throat following intubation in Patients Under General Anaesthesia

Post-operative sore throat refers to irritation or pain in the throat that occurs within 15 minutes to 24 hours after the extubation phase. The incidence of POST has been estimated to range from 6.6% to 90% following tracheal intubation, while the incidence is lower after LMA insertion (17.5%).  POST is one of the major causes of patient dissatisfaction and discharge delays following ambulatory surgery. Routine tracheal intubation for elective surgical procedures can lead to pathological changes, trauma, and nerve damage, which may contribute to postoperative throat symptoms. Various medications, including ketamine, lidocaine, budesonide, dexamethasone, and magnesium sulphate, have been administered via nebulisation, gargling, or intravenous routes to alleviate this issue in different institutions.

While numerous protocols have been proposed to prevent post-operative sore throat (POST), few have attracted significant interest. Various pharmacological and nonpharmacological methods have been explored to decrease POST incidence. Standard treatments include multimodal analgesia and adjuncts such as NSAIDs, lidocaine, and beclomethasone. Additionally, ketamine and magnesium sulphate gargles, as well as nebulization, have been tested, as these substances inhibit the N-methyl-D-aspartic acid receptor without providing direct analgesic effects. Research highlights the influence of factors like endotracheal tube size and cuff pressure on POST, yet literature on the effects of ketamine and magnesium sulphate aerosol is limited. This study aims to compare the impact of ketamine and magnesium sulphate atomizer spray on the occurrence of POST in adult patients undergoing general anaesthesia with endotracheal intubation. The study’s objective is to assess both the incidence of POST and the influence of these atomizer sprays on hemodynamic parameters.