Archives of Anesthesiology and Critical Care 2015. 1(1):8-12.

The Relation between Ketamine Spraying on the Endotracheal Tube Cuff and Reduced Postoperative Sore Throat, Cough and Hoarseness in Parturient Patients
Nasrin Faridi Tazeh kand, Ladan Hosseini, Kamran Yazarlu, Bita Eslami, Soghra Ghorbany Marzony


Background: Tracheal intubation is used in general anesthesia and often leads to traumatization of the airway mucosa. These complications can cause postoperative morbidity. This study was designed to determine the effect of ketamine spraying on the endotracheal tube cuff on sore throat, cough, and hoarseness during the first 24 hours of the postoperative period.

Methods: 120 healthy women with term singleton pregnancy scheduled for elective term cesarean delivery under general anesthesia were enrolled. Patients were randomized into two equal groups. 1 ml (50 mg) ketamine was sprayed on the endotracheal tube cuff in group K as a study group and 1 ml normal saline was sprayed on the endotracheal tube cuff in group N as a control group. The patients were interviewed for sore throat, cough, and hoarseness at  1, 6 and 24 hours after general anesthesia.

Results: In group K, no patient reported sore throat, cough and hoarseness in the first hours after surgery. However at the same time in group N the incidence of these symptoms was significantly higher than group K. The incidence of combined moderate and severe sore throat, cough and hoarseness was significantly lower in group K compared with group N, not only in 6 hours after surgery (1.67%, 0, 0 in group K vs 13.34%, 18.34%, 16.68% in group N, p<0.05) but also 24 hours after operation (1.67%, 0, 0 in group K vs13.3%, 16.6%, 11.67% in group N, p<0.05).

Conclusion: Ketamine spraying on the endotracheal tube cuff reduces the incidence of sore throat, hoarseness and cough in patients undergoing operation under general anesthesia.


ketamine; general anesthesia; sore throat

Full Text:



Ayoub CM, Ghobashy A, Koch ME, McGrimley L, Pascale V, Qadir S, et al. Widespread application of topical steroids to decrease sore throat, hoarseness, and cough after tracheal intubation. Anesth Analg. 1998; 87(3):714-6.

Sumathi P, Shenoy T, Ambareesha M, Krishna H. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Aanaesthesia. 2008; 100(2):215-8.

Borazan H, Kececioglu A, Okesli S, Otelcioglu S. Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study. Survey of Anesthesiology. 2013; 57(1):36.

Hirota K, Lambert DG. Ketamine: its mechanism(s) of action and unusual clinical uses. Br J Anaesth. 1996; 77(4):441-4.

Oye I, Paulsen O, Maurset A. Effects of ketamine on sensory perception: evidence for a role of N-methyl-D-aspartate receptors. J Pharmacol Exp Ther.1992; 260(3):1209-13.

Himmelseher S, Durieux ME. Ketamine for perioperative pain management. Anesthesiology. 2005; 102(1):211-20.

Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U. Ketamine gargle for attenuating postoperative sore throat. Br J Anaesth. 2008; 100(4):490-3.

Rudra A, Ray S, Chatterjee S, Ahmed A, Ghosh S. Gargling with ketamine attenuates the postoperative sore throat. Indian J Anaesth. 2009; 53(1):40.

Higgins P, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002; 88(4):582-4.

Combes X, Schauvliege F, Peyrouset O, Motamed C, Kirov K, Dhonneur G, et al. Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology. 2001; 95(5):1120-4.

Hoffman RJ, Dahlen JR, Lipovic D, Stürmann KM. Linear correlation of endotracheal tube cuff pressure and volume. West J Emerg Med. 2009; 10(3):137-9.

Carlton S, Coggeshall R. Inflammation-induced changes in peripheral glutamate receptor populations. Brain Res. 1999; 820(1-2):63-70.

Carlton SM, Zhou S, Coggeshall RE. Evidence for the interaction of glutamate and NK1 receptors in the periphery. Brain Res. 1998; 790(1):160-9.

Park SY, Kim SH, Noh JI, Lee SM, Kim MG, Kim SH, et al. The effect of intravenous low dose ketamine for reducing postoperative sore throat. Korean J Anesthesiol. 2010; 59(1):22-6.

Zhu MM, Zhou QH, Zhu MH, Rong HB, Xu YM, Qian YN, et al. Effects of nebulized ketamine on allergen-induced airway hyperresponsiveness and inflammation in actively sensitized Brown-Norway rats. Journal Inflammation. 2007; 4(1):10.

Bartoc C, Frumento RJ, Jalbout M, Bennett-Guerrero E, Du E, Nishanian E. RETRACTED: A Randomized, Double-Blind, Placebo-Controlled Study Assessing the Anti-inflammatory Effects of Ketamine in Cardiac Surgical Patients. J Cardio Vasc Anesthesia. 2006; 20(2):217-22.

Ahuja V, Mitra S, Sarna R. Nebulized ketamine decreases incidence and severity of post-operative sore throat. Indian J Anaesth. 2015; 59(1):37-42.

Wood RM. Ketamine for Pain in Hospice Patients. Int J Pharm Compd. 2000; 4(4):253-4.

Crowley K, Flores J, Hughes C, Iacono R. Clinical Application of Ketamine Ointment in the Treatment of Sympathetically Maintained Pain. Int J Pharm Compd. 1997; 2(2):122-7.

Bauchat J, Higgins N, Wojciechowski K, McCarthy R, Toledo P, Wong C. Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial. Int J Obstet Anesth. 2011; 20(1):3-9.

Reza FM, Zahra F, Esmaeel F, Hossein A. Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section. Clin J Pain. 2010; 26(3):223-6.

Han SY, Jin HC, Yang WD, Lee JH, Cho SH, Chae WS, et al. The effect of low-dose ketamine on post-caesarean delivery analgesia after spinal anesthesia. Korean J Pain. 2013; 26(3):270-6.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.