Impact of Pre-Operative Nebulized Lidocaine–Dexmedetomidine Combination Versus Monotherapy on Incidence, Severity, and Patient Comfort Scores of Post-Operative Sore Throat: A Randomized Controlled Clinical Trial

Year : 2026 | Volume : 04 | Issue : 01 | Page : 29 35
    By

    Pratul,

  • Masrata Gull,

  • Abhishek,

  1. Student, Department of Anesthesia, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala, Haryana, India
  2. Student, Department of Radiology, Dolphin PG College, Chunni, Punjab, India
  3. Assistant Professor, Department of Anesthesia, Rayat Bahra University, Mohali, Punjab, India

Abstract

Post-operative sore throat (POST) is a common issue after endotracheal intubation and can reduce patient comfort and hinder recovery. This randomized, double-blind clinical study investigated how effective pre-operative nebulized lidocaine, dexmedetomidine, and their combination are in minimizing POST. Eligible adult patients classified as ASA I–II and scheduled for elective surgery under general anesthesia were randomly assigned to three groups. Nebulization was administered 15–20 minutes before induction using standardized dosing and uniform anesthesia protocol. The primary outcome was incidence of POST within 24 hours. Secondary outcomes included severity grading, patient comfort scores, and associated airway complications. The combination group demonstrated a significantly lower incidence and severity of POST compared to monotherapy groups. Patient comfort scores were consistently improved with combination therapy. Airway-related complications, such as hoarseness and cough, were also reduced. Pre-operative nebulized lidocaine–dexmedetomidine appears to be an effective strategy for minimizing postoperative airway morbidity.

Keywords: Post-operative sore throat, nebulization, lidocaine, dexmedetomidine, endotracheal intubation, airway morbidity, patient comfort score, randomized controlled trial, pre-emptive analgesia, general anesthesia

[This article belongs to International Journal of Biomedical Innovations and Engineering ]

How to cite this article:
Pratul, Masrata Gull, Abhishek. Impact of Pre-Operative Nebulized Lidocaine–Dexmedetomidine Combination Versus Monotherapy on Incidence, Severity, and Patient Comfort Scores of Post-Operative Sore Throat: A Randomized Controlled Clinical Trial. International Journal of Biomedical Innovations and Engineering. 2026; 04(01):29-35.
How to cite this URL:
Pratul, Masrata Gull, Abhishek. Impact of Pre-Operative Nebulized Lidocaine–Dexmedetomidine Combination Versus Monotherapy on Incidence, Severity, and Patient Comfort Scores of Post-Operative Sore Throat: A Randomized Controlled Clinical Trial. International Journal of Biomedical Innovations and Engineering. 2026; 04(01):29-35. Available from: https://journals.stmjournals.com/ijbie/article=2026/view=247058


References

  1. McHardy FE, Chung F. Postoperative sore throat: Cause, prevention and treatment. Anaesthesia. 1999;54(5):444–53.
  2. El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: A systematic review. Anaesthesia. 2016;71(6):706–17.
  3. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582–4.
  4. Jaensson M, Gupta A, Nilsson UG. Risk factors for development of postoperative sore throat and hoarseness after endotracheal intubation. J Clin Anesth. 2012;24(8):567–73.
  5. 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 Nov;95(5):1120–1124. doi:10.1097/00000542-200111000-00014.
  6. Navarro LHC, Lima RM, Aguiar AS, Braz JRC, Carness JM, Módolo NSP. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers. Rev Assoc Med Bras (1992). 2012 Mar-Apr;58(2):248–253. doi:10.1590/S0104-42302012000200025.
  7. Ahuja V, Mitra S, Sarna R. Nebulized ketamine decreases incidence and severity of postoperative sore throat. Anesth Essays Res. 2015;9(1):37–42.
  8. Borazan H, Kececioglu A, Okesli S, Otelcioglu S. Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study. Anesthesiology. 2012 Sep;117(3):512–518. doi:10.1097/ALN.0b013e3182639d5f. PMID: 22797283.
  9. Park SY, Kim SH, Lee AR, Cho SH, Chae WS, Jin HC, et al. Prophylactic effect of dexamethasone in reducing postoperative sore throat. Korean J Anesthesiol. 2010;58(1):15–19. doi:10.4097/kjae.2010.58.1.15.
  10. Abdel-Ghaffar HS, Kamal SM, El Sherif FA, Mohamed SA. Comparison of nebulised dexmedetomidine, ketamine, or midazolam for premedication in preschool children undergoing bone marrow biopsy. Br J Anaesth. 2018 Aug;121(2):445–452. doi:10.1016/j.bja.2018.03.039. PMID: 30032884.
  11. Grewal A. Dexmedetomidine: New avenues. J Anaesthesiol Clin Pharmacol. 2011;27(3):297–302.
  12. Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. Anaesthesia. 1999;54(2):146–65.
  13. Memis D, Hekimoglu S, Vatan I, Yandim T, Yuksel M, Sut N. Effects of midazolam and dexmedetomidine on inflammatory responses and gastric intramucosal pH to sepsis in critically ill patients. Br J Anaesth. 2007;98(4):550–552. doi:10.1093/bja/aem017.
  14. Tanaka Y, Nakayama T, Nishimori M, Tsujimura Y, Kawaguchi M, Sato Y. Lidocaine for preventing postoperative sore throat. Cochrane Database Syst Rev. 2015 Jul 14;2015(7):CD004081. doi:10.1002/14651858.CD004081.pub3. PMID: 26171894.
  15. Hu B, Bao R, Wang X, Liu S, Tao T, Xie Q, Yu X, Li J, Bo L, Deng X. The size of endotracheal tube and sore throat after surgery: a systematic review and meta-analysis. PLoS One. 2013;8(10):e74467. doi:10.1371/journal.pone.0074467.
  16. Takahashi S, Mizutani T, Miyabe M. Effect of tracheal tube cuff pressure on postoperative sore throat. Anesthesiology. 2000;92(2):377–81.
  17. Liu Y, Ai D, Wang X. Efficacy of perioperative intravenous dexmedetomidine administration for the prevention of postoperative sore throat: a meta-analysis. J Int Med Res. 2021;49(5):3000605211017686. doi:10.1177/03000605211017686.
  18. Kuriyama A, Maeda H, Sun R. Topical lidocaine for prevention of postoperative sore throat. Anesth Analg. 2019;129(3):720–7.
  19. Mostafa RH, Saleh AN, Hassan AM. Nebulized lidocaine versus dexmedetomidine for prevention of postoperative sore throat. Ain-Shams J Anaesthesiol. 2020;12(1):18.
  20. Singh NP, Makkar JK, Wadhwa A, Gombar S, Wig J, Kumar B. Comparison of nebulized dexmedetomidine and ketamine for prevention of postoperative sore throat after general anesthesia with endotracheal intubation. Indian J Anaesth. 2021;65(5):373–379. doi:10.4103/ija.
Regular Issue Subscription Review Article
Volume 04
Issue 01
Received 27/02/2026
Accepted 21/03/2026
Published 09/06/2026
Publication Time 102 Days
10

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