A comparison of betamethasone gel and lidocaine jelly as prophylaxis against intubation‑associated throat complications

Background: Sore throat, cough and hoarseness of voice are common postoperative throat complications that follow general anaesthesia with tracheal intubation. Objective: This prospective study was designed to compare the efficacies of lidocaine jelly and betamethasone gel in the prevention of postoperative sore throat, cough and hoarseness after general anaesthesia with tracheal intubation. Materials and Methods: Ninety ASA I and II consenting patients aged 18–65 years were recruited and randomly allocated into three groups of 30 each. The outer surface of the tracheal tube used in intubating patient was lubricated with one of three agents (2% lidocaine jelly, 0.05% betamethasone gel or KY jelly) from the distal tip of the tube to the 15 cm mark. The incidence and severity of sore throat, cough and hoarseness were then assessed by a blinded interviewer at the 6th, 24th and 48th h postoperative. Results: The highest incidence of throat complaints was recorded during the first evaluation at the 6th h postoperative. The incidence of sore throat was 36.7%, 66.7% and 80%; cough was 13.3%, 26.7% and 43.3%; and hoarseness was 23.3%, 30% and 46.7%, for the betamethasone, lidocaine and KY jelly groups, respectively. Betamethasone gel demonstrated significant superiority over lidocaine and KY jellies in the prevention of sore throat (P = 0.002), cough (P = 0.03) and hoarseness (P = 0.03) throughout the study. Duration of tracheal intubation longer than 2 h was associated with significant increase in the incidence of throat complaints (P < 0.001). Conclusion: Application of betamethasone gel on endotracheal tube effectively reduces incidence of postoperative sore throat, cough and hoarseness after tracheal intubation compared to lidocaine jelly.