Clinical Research Directory

Pharyngeal Mucosal Conditioning to Prevent Postoperative Sore Throat in Septoplasty Patients With Severe Nasal Obstruction

Postoperative sore throat (POST) affects 21-65% of patients after endotracheal intubation and is among the most common complaints after general anesthesia. Patients presenting for septoplasty with severe nasal obstruction (NOSE score ≥55) are habitual chronic mouth-breathers, having bypassed nasal air conditioning for months to years preoperatively. This produces a documented state of pharyngeal mucosal dehydration and inflammation that precedes any surgical event - making these patients a distinct high-risk subgroup for POST that has never been identified or studied. This double-blind RCT will test whether a simple, low-cost multimodal pharyngeal mucosal conditioning strategy - nebulized 0.9% normal saline (5 mL over 15 minutes, 30 minutes before induction) combined with a water-soluble lubricant gel applied to the endotracheal tube - reduces POST incidence and severity compared to standard care (sham nebulization plus plain water on the ETT). 105 adults aged 18-60 years with NOSE score ≥55 scheduled for elective septoplasty under general anesthesia will be randomized 1:1. The primary outcome is POST incidence at 1 hour post-extubation assessed by a blinded PACU nurse. Secondary outcomes include POST severity (VAS 0-10) at 1h, 6h, and 24h; hoarseness; dysphagia; PONV; time to first analgesic; and preoperative pharyngeal mucosal hydration measured by the Modified Schirmer Test.

Scheduled Endotracheal Tube Cuff Pressure Management and Postoperative Sore Throat

This randomized controlled trial evaluated whether scheduled measurement and adjustment of endotracheal tube cuff pressure using a handheld manometer could reduce postoperative sore throat in adults undergoing elective surgery under general anesthesia with tracheal intubation. Participants were randomly assigned in a 1:1 ratio to either manometer-guided cuff-pressure management or conventional cuff inflation based on pilot-balloon palpation. In the manometer-guided group, cuff pressure was maintained within a target range of 25-30 cmH₂O. In the conventional group, cuff inflation was managed according to the attending anesthesiologist's usual clinical assessment. Cuff pressure was assessed at predefined time points during anesthesia. Postoperative sore throat was evaluated at 1, 6, and 24 hours after extubation. Other postoperative airway symptoms, including hoarseness, difficulty swallowing, cough, and postoperative nausea or vomiting, were also assessed. The main objective was to determine whether scheduled manometer-guided cuff-pressure management reduced the occurrence of postoperative sore throat within the first 24 hours after surgery compared with conventional pilot-balloon palpation.

Dexmedetomidine Nasal Spray and Postoperative Sore Throat After Bronchoscopy

The goal of this observational study is to learn whether dexmedetomidine nasal spray is associated with a lower risk of postoperative sore throat in adult patients who underwent bronchoscopy under general anesthesia. The main questions it aims to answer are: Is dexmedetomidine nasal spray associated with a lower incidence of sore throat after bronchoscopy? What is the average treatment effect of dexmedetomidine nasal spray on postoperative sore throat? Does the treatment effect differ across patient subgroups (treatment effect heterogeneity)? Researchers will compare patients who received dexmedetomidine nasal spray with patients who did not receive it to see if the nasal spray is associated with less postoperative sore throat, and whether some patients benefit more than others. This is a two-center retrospective cohort study. No participants will be asked to do anything, and no interventions will be given. Existing medical records of patients who underwent bronchoscopy will be analyzed. The analysis follows a target trial emulation framework, which mimics a randomized trial using existing data, and uses statistical and machine learning methods to account for differences between patient groups.

The Effect of Compound Chamomile and Lidocaine Hydronchloride Gel as an Endotracheal Tube Lubricant on Postoperative Pharyngeal and Laryngeal Complications in Thoracic Surgery Patients

Total anesthesia is the most commonly used anesthesia method in clinical surgery, which can reduce hospital stay and improve patient comfort on the basis of ensuring patient surgery safety. However, for patients with total anaesthetic tracheotomy, the incidence of throat complications such as throat pain, wheezing, and coughing after tracheotomy removal remains high. According to literature reports, the incidence of throat pain can reach 40% after total anaesthetic tracheotomy removal, the incidence of wheezing is 24%, and the related throat symptoms can persist until 24 hours or even longer after surgery. This phenomenon is particularly notable in patients with thoracic surgery.The high incidence of laryngeal pain after thoracic surgery is the result of the combination of mechanical stimulation of the bronchial / bilateral bronchial catheter, air sac pressure, surgery time and position, individual susceptibility factors of the patient, and technical details of intubation/entubation. Although such laryngeal complications are milder compared to other anesthetic complications, they can reduce the patient's post-operative hospitalization comfort and satisfaction, and even prolong the hospitalization time, affecting clinical treatment effectiveness and patient admission experience.This study aims to explore the effect of polycamomile lidocaine gel as a bronchial catheter lubricant on postoperative laryngeal complications in patients undergoing thoracic surgery. It aims to provide new ideas and clinical basis for optimizing clinical drug administration protocols and reducing the incidence of postoperative laryngeal complications for patients undergoing thoracic surgery with total anaesthetic bronchial intubation.

Effect of Laryngeal Mask Cuff Shape on Pharyngeal Stress

Laryngeal masks are widely used supraglottic airway devices, but their cuffs differ considerably in shape and design. The cuff exerts pressure on the pharyngeal structures, which may provoke a physiological stress response and contribute to postoperative pharyngeal complaints. This prospective, randomized, two-centre trial compares three commercially available laryngeal masks with different cuff designs (SaCoVLM, LMA Supreme and Ambu AuraGain) in 162 adult patients undergoing elective surgery under general anaesthesia. Anaesthesia induction is standardized and guided by State Entropy, and cuff pressure is standardized to 40-50 cmH2O in all groups. The primary outcome is the change in mean arterial pressure after laryngeal mask insertion. Secondary outcomes include heart rate, nociception and depth-of-anaesthesia indices (Surgical Pleth Index, Response Entropy - State Entropy difference), insertion characteristics, oropharyngeal leak pressure and postoperative pharyngolaryngeal complaints up to 24 hours. The hypothesis is that cuff shape modifies the stress exerted on the pharynx and thereby influences the patient's stress response.

Effect of Loss-of-Resistance Syringe Training on Endotracheal Tube Cuff Pressure

This study will examine whether training the anesthesia team in a loss-of-resistance syringe technique is associated with improved breathing-tube cuff pressure in adults having surgery at Kayseri City Hospital. The cuff is an inflatable seal around the breathing tube. Pressure that is too high or too low may cause problems. Approximately 180 adults will be observed during a two-week period before staff training and a two-week period after training. The treating clinical team will independently choose how to inflate each cuff as part of routine care; researchers will not assign patients to a technique. A researcher independent of the treating team will measure cuff pressure and will learn which technique was used only after the measurement. The main outcome is the percentage of patients whose first measured cuff pressure is within 20-30 cmH2O, compared between the periods before and after training. Pressures outside this range will be corrected for patient safety after the first measurement is recorded. Researchers will also record cuff leakage, the need for additional air, and sore throat after the breathing tube is removed, once the patient is awake and able to answer questions.

Testing Two Doses of Nebulized Ketamine for Postoperative Sore Throat

Postoperative sore throat (POST) is one of the most common complications following general anesthesia with endotracheal intubation, affecting patient comfort, delaying recovery, and reducing overall satisfaction with perioperative care. Although POST is usually self-limiting, its high incidence makes it an important target for preventive interventions. Nebulized ketamine has emerged as a promising non-invasive strategy for reducing POST because of its local analgesic and anti-inflammatory effects mediated through N-methyl-D-aspartate (NMDA) receptor antagonism. Previous randomized trials and systematic reviews have demonstrated that nebulized ketamine can reduce both the incidence and severity of POST compared with placebo. However, most published studies have evaluated a single 50-mg dose, and the minimum effective dose remains uncertain. This prospective, randomized, placebo-controlled, double-blind clinical trial aims to compare the efficacy and safety of two preoperative doses of nebulized ketamine (25 mg and 50 mg) with placebo in adult patients undergoing elective surgery under general anesthesia with endotracheal intubation. Participants aged 18-65 years with American Society of Anesthesiologists (ASA) physical status I or II will be randomly assigned in a 1:1:1 ratio to receive nebulized ketamine 25 mg, nebulized ketamine 50 mg, or nebulized normal saline 15 minutes before induction of anesthesia. The primary outcome is the incidence of postoperative sore throat assessed at 2, 4, 6, 12, and 24 hours after surgery using a standardized four-point grading scale. Secondary outcomes include the severity of POST, postoperative pain intensity measured using the Visual Analog Scale (VAS), patient satisfaction, need for rescue analgesia, sedation assessed using the Ramsay Sedation Scale, and the incidence of adverse effects, including nausea, dizziness, and hallucinations. The study hypothesizes that a lower dose of nebulized ketamine (25 mg) will provide comparable protection against postoperative sore throat to the conventional 50-mg dose while minimizing dose-related adverse effects. Identifying the minimum effective dose may improve the safety profile, optimize perioperative patient comfort, and support evidence-based recommendations for preventing postoperative sore throat after endotracheal intubation.

Comparison of Postoperative Sore Throat Following Endotracheal Intubation Performed With Videolaryngoscope, Videostylet, and Fiberoptic Bronchoscope

This study aims to compare video laryngoscope (VL), video stylet (VS), and fiberoptic bronchoscope (FOB) in elective endotracheal intubations of patients aged 18 to 65 years, classified as ASA I-II and without predicted difficult airways. The primary endpoints are the incidence of postoperative sore throat and hoarseness, while secondary endpoints include intubation time, first-attempt intubation success, hemodynamic responses, and procedure-related complications. Postoperative sore throat and hoarseness will be assessed at the bedside at the 20th minute and 6th hour following extubation.

Low-Flow Sevoflurane and Desflurane Anesthesia in Laparoscopic Cholecystectomy

Several studies have demonstrated that inhalational anesthetic agents such as desflurane and sevoflurane may cause varying degrees of postoperative sore throat, hoarseness, and cough in orotracheally intubated patients. However, data evaluating these outcomes under low-flow anesthesia conditions remain limited and insufficient. This single-center, prospective, randomized controlled study will be conducted in patients aged 18-65 years, classified as American Society of Anesthesiologists (ASA) physical status I-II, who are scheduled to undergo elective laparoscopic cholecystectomy under general anesthesia and who provide written informed consent to participate in the study. The primary objective of the study is to compare the effects of low-flow desflurane and low-flow sevoflurane anesthesia on the incidence and severity of postoperative sore throat. The secondary outcomes include the evaluation of postoperative hoarseness and cough, the incidence of postoperative nausea and vomiting (PONV), and the total consumption of inhalational anesthetic agents.

Effect of Inflated Versus Non-inflated Endotracheal Tube on Sore Throat

Postoperative sore throat (POST) is a common morbidity following upper airway access-control with direct laryngoscopy-intubation (DLI) technique. Various reasons (size of the tracheal tube, cuff pressure, rough tube pass, and reattempts, among others) have been cited and management strategies (pharmacologic: applying lidocaine gel/EMLA cream on the cuff surface; non-pharmacologic measures: tracheal tube cuff pressure control, optimization of tracheal tube size, applying lubricating gel) have been tried, but none has been able to decrease the incidence of POST nor has been able to decrease the suffering of patients. Traditionally, intubation is performed with a deflated endotracheal tube and the cuff is later inflated to secure the tube in desired position. The striated folds present in the deflated cuff incurs additional dynamic friction that traumatizes upper airway mucosa during the procedure, causing the risk of POST. While accentuated friction burden on the posterior part of vocal cords and the tracheal mucosa has been studied recently, there has been no work on understanding the kinetic contact- friction ensued by a passing tracheal tube/cuff. We speculate that dynamic contact-friction generated at the time of passing of a cuffed tracheal tube is the major active component which has potential to cause actual tissue trauma and inflammation resulting in adverse effects (POST, hoarseness, throat pain, cough). This study aims to evaluate the effects of reducing dynamic/kinetic contact-friction by employing a pre-inflated tracheal tube cuff to pass the vocal cords at the time of orotracheal intubation.

A Randomized, Comparative, Controlled Study of Differences in the Incidence of Postoperative Sore Throat (POST) by Inner Diameter Size of the TaperGuardTM Endotracheal Tube (ETT)

Postoperative sore throat (POST) is a common complication following general anesthesia involving endotracheal intubation, often leading to decreased patient satisfaction. The TaperGuard™ endotracheal tube (ETT) features a tapered-shaped cuff designed to reduce micro-aspiration and has been shown to result in a lower incidence of POST compared to conventional cylindrical ETTs. While previous studies using standard cylindrical ETTs suggested that a smaller inner diameter (ID) reduces the risk of POST, this relationship has not been fully established specifically for the TaperGuard™ ETT. This study aims to compare the incidence of POST between a standard-sized TaperGuard™ ETT (ID 7.0 mm) and a smaller-sized TaperGuard™ ETT (ID 6.0 mm) in female patients. The investigators hypothesize that using a smaller ID TaperGuard™ ETT will significantly reduce the occurrence of POST within 24 hours after surgery. Patients will be randomly assigned to either the control group (ID 7.0 mm) or the small group (ID 6.0 mm). Throughout the procedure, cuff pressure will be strictly maintained at 22 cmH2O to minimize mucosal damage. The primary outcome is the presence of sore throat, and secondary outcomes include the severity of the pain and the incidence of hoarseness at several time points up to 24 hours postoperatively.

Comparison of Nebulized Ketamine With Nebulized Magnesium Sulfate for the Prevention of Postoperative Sore Throat

The aim of this study is to compare the efficacy of nebulized ketamine versus nebulized magnesium sulfate in reducing the incidence and severity of POST. * Primary outcome • To compare the incidence of POST method. * Secondary outcomes * Onset, Severity, and duration of POST at 0, 2, 4, 6, 12, 24 hours postoperative. * The hemodynamics recording (HR, BP, MBP, pre and post nebulization) * Adverse Effects (e.g., sedation, cough, nausea, vomiting, ….)

Effect of Cuff Pressure Assessment Methods on Postoperative Complications in Breast Surgery

Endotracheal intubation is a standard procedure used to secure the airway during general anesthesia. A key component of the breathing tube is the "cuff," a balloon-like device that is inflated to seal the airway and prevent aspiration. However, if the pressure within this cuff is too high, it can restrict blood flow to the tracheal lining, leading to complications such as postoperative sore throat, hoarseness, and difficulty swallowing (dysphagia). Currently, there are various methods to monitor and adjust this pressure. In many clinical practices, the pressure is adjusted subjectively or checked only once at the beginning of the surgery. These methods may allow pressure to exceed safe limits (typically 20-30 cmH₂O) or fluctuate during the procedure, potentially causing tissue irritation. This randomized controlled trial aims to compare three different methods of assessing and maintaining endotracheal tube cuff pressure to determine which is most effective at reducing postoperative complications. The study focuses on women undergoing elective breast surgery, a group chosen because the surgery typically lasts 1-3 hours and does not involve major changes in head and neck position, allowing for a clear assessment of the cuff pressure methods. Participants will be randomly assigned to one of three groups: * Continuous Monitoring Group: Cuff pressure is monitored continuously using a pressure indicator and maintained within the 20-30 cmH₂O range throughout the surgery. * Manometer Group: Cuff pressure is measured and set to 20-30 cmH₂O using a manual manometer once, immediately after intubation. * Control Group (Minimal Occlusive Volume): The cuff is inflated with the minimum amount of air required to prevent an air leak, without using a pressure gauge. Researchers will assess patients for sore throat, cough, hoarseness, and swallowing difficulties at 0, 1, 12, and 24 hours after surgery to identify the safest and most comfortable method for airway management.

Establishment of Prediction Model for Postoperative Sore Throat

This observational study aims to identify the risk factors associated with postoperative sore throat (POST) and to develop a clinical prediction model for patients undergoing thyroid surgery under general anesthesia. Despite improvements in surgical and anesthetic techniques, POST remains one of the most common complications following thyroidectomy, with an incidence of up to 80%. POST can significantly impact patient comfort, swallowing function, nutritional intake, and recovery quality, leading to prolonged hospitalization and increased healthcare costs. The etiology of POST is multifactorial, involving intubation-related factors (e.g., endotracheal tube size, cuff pressure), surgery-related factors (e.g., duration of surgery, neck hyperextension), and patient-related factors (e.g., age, sex, smoking history, pre-existing throat symptoms). However, large-scale, systematic studies in the Chinese population remain limited. With the increasing adoption of Enhanced Recovery After Surgery (ERAS) principles, the accurate identification of modifiable risk factors and early prediction of POST risk are essential for targeted preventive strategies and improved perioperative management. Recent advancements in machine learning and statistical modeling allow for the development of personalized, multifactorial risk assessment tools. In this study, clinical data from patients undergoing thyroid surgery at Nanjing First Hospital will be collected and analyzed. The primary goal is to identify key preoperative and intraoperative predictors of POST and to establish a multivariable nomogram-based prediction model. Internal validation using bootstrap methods will be performed to evaluate the model's discrimination, calibration, and clinical utility, ultimately supporting evidence-based interventions to improve postoperative outcomes and patient satisfaction.

the Impact of Ketamine Gargling on the Incidence of Post Intubation Sore Throat

Tracheal intubation often causes trauma to the airway mucosa, leading to postoperative sore throat (POST), which has been reported to occur in 21-65% of cases. While considered a minor complication, POST can contribute to postoperative discomfort and patient dissatisfaction.