Combined Effect of Thermosoftening with Dexamethasone on the Larygopharyngeal Injury following One Lung Anesthesia using Double Lumen Tube

Abstract

Introduction Hoarseness and sore throat are common layryngopharyngeal complications following endotracheal intubation. Thermosoftening method and intravenous administration of dexamethasone are known to be effective reducing the laryngopharyngeal complications. We combined two methods of thermosoftening of DLT and prophylactic dexamethasone administration 0.1mg/kg to minimize the larynopharyngeal injury during DLT intubation.

Methods Patients (n=157) undergoing thoracic surgery using DLT were randomized into three groups. Group TD (thermosoftening + dexamethasone), whose DLT was thermosoftened with 40℃ normal saline bottle and received intravenous administration of dexamethasone 0.1mg/kg

Group D (no thermosoftening + dexamethasone) whose DLT was not thermosoftened and received intravenous administration of dexamethasone 0.1 mg/kg

Group C (no thermosoftening + 0.9% saline) whose DLT was not thermosoftened and received a placebo of 0.9% saline. Hoarseness and sore throat were evaluated until second postoperative days.

Results The incidence of hoarseness at had significant differences among the three groups (P=0.028). Group TD showed lower incidence of hoarseness at 24 hour compared with Group C (17% vs 42%, P=0.008). The incidence of sore throat was comparable between the three groups.

Conclusions Combined treatment of thermosoftening and intravenous administration of dexamethasone 0.1 mg/kg can reduce the postoperative hoarseness at 24 hour following one lung anesthesia using double lumen tube.