Yildiz Pelin, Hemmati Mobin, Kutlucan Leyla, Uzun Tankut, Müderris Togay
Department of Otorhinolaryngology, Faculty of Medicine, İzmir Bakırçay University, Çiğli Training and Research Hospital, İzmir, Turkiye.
Department of Anesthesiology and Reanimation, Faculty of Medicine, İzmir Bakırçay University, Çiğli Training and Research Hospital, İzmir, Turkiye.
Turk J Med Sci. 2025 Jul 8;55(4):912-919. doi: 10.55730/1300-0144.6044. eCollection 2025.
BACKGROUND/AIM: Postoperative sore throat (POST) is a common complication following general anesthesia that significantly affects patient satisfaction, prolongs recovery, and increases treatment costs. This study aimed to evaluate whether the addition of antimicrobial agents to NSAID-based oral sprays could enhance the preventive efficacy against POST.
In this prospective, randomized, placebo-controlled trial, 105 patients (ASA I-II; age 18-65 years) scheduled for elective ear surgery under general orotracheal anesthesia were enrolled. Patients were randomly allocated into three groups: a placebo group; a flurbiprofen oral spray group; and a group receiving an oral spray containing benzydamine hydrochloride, chlorhexidine digluconate, and cetylpyridinium chloride. The sprays were administered under direct laryngoscopy before intubation and after the final oropharyngeal aspiration. POST severity was assessed using a 10mm Visual Analog Scale (VAS) at 1 h, 6 h, 24 h, and 1 week postoperatively. Patients were also subgrouped based on surgical duration (<120 min vs. ≥120 min).
Both NSAIDbased treatments significantly reduced VAS scores at early postoperative time points compared to the placebo. In subgroup analysis, patients undergoing surgeries lasting less than 120 min exhibited lower VAS scores with both active treatments, while in those with surgeries ≥120 min, significant differences were noted at 1 and 6 h. No significant difference was found between the flurbiprofen spray and the combination spray.
NSAIDcontaining oral sprays effectively reduce the severity of postoperative sore throat. However, the addition of antimicrobial agents does not provide extra analgesic benefit, suggesting that simpler, costeffective NSAID formulations may be preferable in clinical practice.
背景/目的：术后咽痛（POST）是全身麻醉后常见的并发症，会显著影响患者满意度、延长恢复时间并增加治疗成本。本研究旨在评估在基于非甾体抗炎药（NSAID）的口腔喷雾剂中添加抗菌剂是否能增强对POST的预防效果。
在这项前瞻性、随机、安慰剂对照试验中，纳入了105例计划在经口气管插管全身麻醉下进行择期耳部手术的患者（美国麻醉医师协会身体状况分级I-II级；年龄18-65岁）。患者被随机分为三组：安慰剂组；氟比洛芬口腔喷雾剂组；以及接受含有盐酸苄达明、葡萄糖酸氯己定和氯化十六烷基吡啶的口腔喷雾剂的组。在插管前和最后一次口咽吸引后，通过直接喉镜将喷雾剂给药。在术后1小时、6小时、24小时和1周时，使用10毫米视觉模拟量表（VAS）评估POST严重程度。患者还根据手术持续时间（<120分钟与≥120分钟）进行亚组分析。
与安慰剂相比，两种基于NSAID的治疗在术后早期时间点均显著降低了VAS评分。在亚组分析中，手术持续时间少于120分钟的患者在两种活性治疗下VAS评分较低，而在手术时间≥120分钟的患者中，在1小时和6小时时观察到显著差异。氟比洛芬喷雾剂和联合喷雾剂之间未发现显著差异。
含NSAID的口腔喷雾剂可有效降低术后咽痛的严重程度。然而，添加抗菌剂并未提供额外的镇痛益处，这表明在临床实践中，更简单、成本效益更高的NSAID制剂可能更可取。
