Comparative Study of the Preventive Effect of Two Different Doses of Intra-Cuff Dexamethasone on Sore Throat After Tracheal Tube Removal in Patients Undergoing Cesarean Section

Abstract

Background: Postoperative sore throat (POST) is a common complication following endotracheal intubation during general anesthesia, often impacting patient comfort and recovery. Dexamethasone, a glucocorticoid known for its anti-inflammatory properties, has been studied for its role in reducing POST, though the optimal dosage and route of administration remain under debate. Methods: This prospective randomized triple-blind study compared the efficacy of intracuff dexamethasone at doses of 4 mg and 8 mg in reducing the incidence and severity of POST in women undergoing cesarean section. A total of 60 participants were randomly assigned to one of three groups: a control group receiving saline and two experimental groups receiving intracuff dexamethasone at 4 mg and 8 mg, respectively. The primary outcome measured was the severity of POST, assessed at 0, 6, 12, 18, and 24 hours postoperatively. Secondary outcomes included patient satisfaction and time to tolerate liquids and solids post-surgery. Findings: According to the results, the mean severity of sore throat was significantly reduced in both the 8 mg and 4 mg dexamethasone groups (1.57 ± 1.15), (1.89 ± 1.47) (P < 0.05). Moreover, the 8 mg dexamethasone group demonstrated a significantly lower mean sore throat score compared with the control group (0.52 ± 0.24), (1.19 ± 0.88), (P < 0.01). Although the severity and intensity of sore throat were lower in the 8 mg group compared to the 4 mg group, this difference did not reach statistical significance (P = 0.78). Patient satisfaction was also higher in the 8 mg dexamethasone group compared with both the 4 mg and control groups (P < 0.01, P < 0.05). Conclusion: Our findings suggest that while both dosages effectively reduce POST, higher doses may enhance patient comfort and satisfaction. Further studies are needed to explore the long-term implications of higher dexamethasone doses in various patient populations. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved.