The aim of the study is to compare the effect of nebulized Dexmedetomidine compared to nebulized Lidocaine on postoperative sore throat in childern undergoing Tonsillectomy.
Tonsillectomy is one of the most commonly performed day-case surgeries in pediatric patients. Despite its routine nature, post operative sore throat (POST) remains significant cause of morbidity, leading to discomfort and reduced parental satisfaction(1) POST ranked sixth among the 10 most undesirable adverse effects related to general anesthesia (2). Irritation and inflammation of the airway caused by pressure exerted on the tracheal wall by the endotracheal tube (ETT)(3) trauma during intubation and mucosal dehydration(4) are thought to be the mechanistic basis for a postoperative sore throat (POST) During tonsillectomy, the shared surgical and anesthetic field poses a risk of airway manipulation, necessitating close cooperation between surgeon and anesthesiologist to maintain adequate oxygenation and a clear operative field(5) Intraoperative blood or fluid aspiration can further exacerbate upper airway irritation, contributing to POST(6) Given the impact of POST on patient well-being, effective preventive strategies are essential for optimizing postoperative recovery (7) Nebulization therapy is widely used to prevent POST. It is highly recommended because of small volume of drugs required for effect, easy way of administration, better patient compliance, and most importantly little risk of adverse events compared with other methods(such as gargle, intravenous, etc.)(8) Commonly used aerosolized drugs include corticosteroids, ketamine, magnesium, lidocaine, Non-steroidal anti-inflammatory drugs(NSAIDs), etc. and have achieved various effects(9\_12) Previous studies showed promising results for both Nebulized Dexmedetomidine and Nebulized Lidocaine in Attenuating Sore Throat(13\_14) , yet no study has directly compared the efficacy of Nebulized Dexmedetomidine Versus Nebulized Lidocaine in Attenuating Sore Throat Following Tonsillectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
70
group D (Dexmedetomidine group) will recieve a dose of 1 mcg/kg
will recieve Lidocaine 2%, 1 mg/kg
Fayoum university Hospitl
Al Fayyum, Egypt
RECRUITINGIncidence of Postoperative Sore Throat (POST)
Time frame: immediately on PACU
Severity of sore throat (ST)
specifically at the 4th postoperative hour. ST was scored on a four-point scale (0-3) (20) 0 =No ST 1. =mild ST (complains of ST only on asking); 2. =moderate ST (complains of ST on his/her own) 3. =severe ST (change in voice or hoarseness, associated with throat pain).
Time frame: at the 4th postoperative hour
*Hemodynamic Parameters
Heart Rate
Time frame: every 5 minutes intraoperatively and at 0,1,3,6,12 and 24hrs postoperatively
Hemodynamic Parameters
Mean Arterial Blood Pressure
Time frame: every 5 minutes intraoperatively and at 0,1,3,6,12 and 24hrs postoperatively
Hemodynamic Parameters
Oxygen Saturation ( SPO2 )
Time frame: every 5 minutes intraoperatively and at 0,1,3,6,12 and 24hrs postoperatively
evaluation of other adverse effects
such as nausea, vomiting and cough
Time frame: during the first postoperative hour.
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