Intravenous Dexamethasone vs. Ketamine Gargle vs. Intravenous Dexamethasone Combined with Ketamine Gargle for Evaluation of Post-Operative Sore Throat and Hoarseness: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial

Sore throat and hoarseness are the most frequent subjective complaints after tracheal intubation for general anesthesia. We conducted a prospective، randomized، double-blind، placebo controlled study to evaluate the efficacy of intravenous dexamethasone plus ketamine gargle for reducing the incidence and severity of post-operative sore throat (POST) and hoarseness. 140 patients (aged 16-65 years) scheduled for elective surgery were enrolled. Patients were randomly allocated into four groups of 35 subjects: group K gargled 40 mg ketamine in 30 ml saline; group D were infused 0. 2 mg/kg intravenous (IV) dexamethasone; group KD gargled 40 mg ketamine in 30 ml saline plus 0. 2 mg/kg intravenous dexamethasone; and group P (placebo) received saline (gargle and IV). POST was graded at 0، 2، 4، 8، 16 and 24 hours after operation on a four-point scale (0–3). The incidence and severity of POST were significantly lower in group KD، compared with the other groups at all times after tracheal extubation for up to 24 hours (P < 0. 05). Also، the incidence and severity of hoarseness were significantly lower in groups of KD، K and D compared with group P (P < 0. 05). The prophylactic use of 0. 2 mg/kg of intravenous dexamethasone plus ketamine gargle significantly reduced the incidence and severity of POST compared with using each of these drugs alone or using placebo.