Comparison Between Betamethasone Gel and Lignocaine Gel Applied Over Endotracheal Tube to Prevent Postoperative Sore Throat and Hoarseness of Voice

Abstract

Introduction: Post-operative sore throat (POST) and hoarseness of voice (HOV) are common complications following general anaesthesia with endotracheal intubation. Various preventive strategies have been investigated, including the application of lignocaine and steroid gel over the endotracheal tube.

Aim: To compare the effectiveness of betamethasone gel and lignocaine gel in preventing POST and HOV.

Methodology: This prospective, double-blinded, interventional comparative study was conducted over six months at Nepalgunj Medical College Teaching Hospital after institutional ethical approval. Ninety-nine ASA I–II patients aged 18–70 years undergoing general anaesthesia with planned endotracheal intubation were enrolled. Using an opaque sealed envelope technique, patients were randomly divided into three groups: betamethasone gel (Group 1), lignocaine gel (Group 2), and normal saline (Group 3) applied to the endotracheal tube before intubation. Statistical analysis included ANOVA, Chi-square, Kruskal–Wallis, Mann–Whitney U, and Cochran’s Q tests, with p < 0.05 considered statistically significant.

Results: The incidence of POST and HOV was significantly lower in the betamethasone group compared with the lignocaine and control groups (POST: p = 0.046 and 0.005; HOV: p = 0.024 and 0.013, respectively). POST severity at 1 and 6 hours was also significantly lower in the betamethasone group. HOV at 1 hour was reduced with betamethasone (p values 0.012). Outcomes in the lignocaine and control groups were comparable. Across all groups, POST and HOV decreased significantly over time (p values 0.001).

Conclusion: Betamethasone gel effectively reduces the incidence and severity of POST and HOV, particularly in the early postoperative period.