thiopental and Pharyngitis

The insertion of a laryngeal mask airway (LMA) may result in postoperative sore throat. The choice of induction drug on airway morbidity after LMA insertion may be important. We performed this study to compare the incidence of postoperative pharyngeal morbidity after the insertion of a LMA in 340 patients administered either 2 mg/kg propofol (group P) or thiopental 5 mg/kg (group T) for induction of anesthesia. Patients were maintained at 1-2 minimum alveolar anesthetic concentration sevoflurane in 50% oxygen/air. Spontaneous or assisted spontaneous ventilation was maintained. An investigator blinded to group allocation visited patients at 2, 12, and 24 h postoperatively. Adverse responses were noted (yes/no) at each time point including sore throat, sore mouth, sore jaw, hoarseness, dysphonia, and dysphagia. At 2 h postoperatively, the incidence of sore throat, dysphagia, and postoperative nausea and vomiting in group T was higher than in group P (24% vs 13% for sore throat, 15% vs 3% for dysphagia, 20% vs 11% for nausea, 14% vs 6% for vomiting, P < 0.05). The number-needed-to-treat to prevent sore throat and dysphagia was 10 and 8, respectively (95% confidence intervals, 5-43). We concluded that, when propofol, rather than thiopental, is used for the induction of anesthesia, it results in a lower incidence of early pharyngeal morbidity and postoperative nausea and vomiting after the insertion of a LMA.

Topics: Adult; Aged; Analgesics; Anesthetics, Intravenous; Deglutition Disorders; Double-Blind Method; Female; Humans; Incidence; Laryngeal Masks; Male; Middle Aged; Pain, Postoperative; Patient Satisfaction; Pharyngitis; Postoperative Nausea and Vomiting; Propofol; Prospective Studies; Thiopental; Time Factors; Treatment Outcome

The present prospective study investigates the impact of a standardized technique of spinal and general anaesthesia on the incidence and consequences of postanaesthetic complaints dependent on age and sex of patients.. 433 orthopaedic patients underwent lower limb surgery in spinal (group 1) or general (group 2) anaesthesia. Spinal anaesthesia was performed with 0.5% hyperbaric bupivacaine using a 26-gauge Quincke needle. General anaesthesia was induced with i.v. injection of thiopentone, fentanyl and atracurium and maintained with 65% nitrous oxide and 1-1.5 Vol% isoflurane in oxygen. On postoperative day 4, patients were interviewed for onset and duration of postoperative complaints.. The overall incidence of nausea/vomiting (P = 0.025) and sore throat (P = 0.0001) was higher in group 2. In addition, nausea/vomiting was higher in patients between 20 and 60 years in group 2 compared with group 1. While the incidence of urinary dysfunction was higher in men after spinal (P = 0.04), nausea/vomiting was more frequent in women after general anaesthesia (P = 0.008). Analgetic requirements (P = 0.013), time of postoperative surveillance (P = 0.042) and frequency of treatment of postoperative complaints (P = 0.0001) was higher in group 2.. Spinal anaesthesia was associated with a lower incidence of postoperative complaints and treatments and a shorter surveillance compared to general anaesthesia. Specific complications related to spinal anaesthesia did not depend on age or sex and may allow for recommendation of this technique even in younger and female patients undergoing orthopaedic surgery.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, General; Anesthesia, Spinal; Anesthetics, Inhalation; Anesthetics, Intravenous; Female; Humans; Isoflurane; Leg; Low Back Pain; Male; Middle Aged; Nausea; Orthopedics; Pharyngitis; Postoperative Complications; Prospective Studies; Thiopental; Urination Disorders; Vomiting

Recent reports of the incidence of postoperative sore throat following anaesthesia with tracheal intubation have claimed that low volume high pressure cuffs are preferable to those with high volume and low pressure. In this study similar methods were used for evaluating postoperative sore throat. Randomly selected tracheal tubes were used in 56 patients undergoing elective abdominal surgery, followed by direct questioning about sore throat on the first postoperative day. The incidence of postoperative sore throat was 41 per cent with high volume low pressure cuffed tubes and 55 per cent with low volume high pressure cuffed tubes. This difference is not statistically significant, but the tendency of the results is contradictory to those published earlier. The incidence of postoperative sore throat varies greatly if direct or indirect questioning is used and also varies between studies using the same method of questioning. Therefore the validity of this method for evaluating the influence of cuff design must be questioned. Postoperative sore throat is a symptom caused by many factors, such as the intubation procedure and the use of stylets or lubricants. The incidence of postoperative sore throat does not necessarily reflect damage caused by the tracheal tube cuff.

Topics: Anesthesia; Female; Humans; Intubation, Intratracheal; Male; Pharyngitis; Postoperative Complications; Thiopental

Topics: Analgesics; Anesthetics, Intravenous; Deglutition Disorders; Humans; Laryngeal Masks; Pain, Postoperative; Pharyngitis; Postoperative Nausea and Vomiting; Pressure; Propofol; Thiopental; Time Factors

Topics: Anesthesia, Intravenous; Anesthetics, Intravenous; Ascorbic Acid; Back Pain; Drug Combinations; Humans; Muscle, Skeletal; Pain, Postoperative; Pharyngitis; Placebos; Propofol; Thiopental

Topics: Ambulatory Care; Bronchoscopy; Humans; Male; Muscles; Pain; Pharyngitis; Propanidid; Succinylcholine; Thiopental