The effect of dexmedetomidine and remifentanil on the postoperative sore throat after thyroidectomy

• Published in: Medicine (Baltimore) Vol. 99; no. 29; p. e21060
• Main Authors: Kim, Hyuckgoo, Kwon, Hyojin, Jeon, Sungmin, Choi, Eun Kyung
• Format: Journal Article
• Language: English
• Published: United States the Author(s). Published by Wolters Kluwer Health, Inc 17-07-2020; Wolters Kluwer Health
• Subjects: Adult; Analgesics, Non-Narcotic - standards; Analgesics, Non-Narcotic - therapeutic use; Analgesics, Opioid - standards; Analgesics, Opioid - therapeutic use; Clinical Trial/Experimental Study; Dexmedetomidine - standards; Dexmedetomidine - therapeutic use; Female; Humans; Intubation, Intratracheal - adverse effects; Male; Middle Aged; Pharyngitis - drug therapy; Pharyngitis - etiology; Postoperative Complications - drug therapy; Postoperative Period; Remifentanil - standards; Remifentanil - therapeutic use; Thyroidectomy - adverse effects; Thyroidectomy - methods
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000021060

Postoperative sore throat (POST) is an important concern in surgical patients undergoing endotracheal intubation. Its prevalence after thyroidectomy is up to 80%. The current study aimed to assess the effect of dexmedetomidine and remifentanil on postoperative sore throat.
Seventy-four patients who underwent thyroidectomy were randomized to receive either dexmedetomidine (group D) or remifentanil (group R). At anesthesia induction, group D received dexmedetomidine 1 μg/kg over 10 minutes, followed by continuous dexmedetomidine infusion at 0.3 to 0.6 μg/kg/hour during surgery. Group R received remifentanil of 3 to 4 ng/ml during induction, followed by 1.5 to 2.5 ng/ml remifentanil infusion during surgery. POST at rest and swallowing was assessed during the first 24 hours in serial time periods (0-1, 1-6, and 6-24 hours). Hoarseness and postoperative pain score were also assessed.
POST incidence at rest (0-1, 1-6, and 6-24 hours) and swallowing (1-6 and 6-24 hours) was lower in group D than in group R. POST severity was significantly lower in group D than in group R during each time period. The incidence of postoperative hoarseness was also lower in group D than in group R at 1 to 6 and 6 to 24 hours. The postoperative pain score was lower in group D than in group R during each time period.
Intraoperative dexmedetomidine infusion reduced the incidence and severity of POST for 24 hours after thyroidectomy.