Evaluation of the Effect of Three Different Doses of Intranasal Dexamethasone in Preventing Postoperative Sore Throat in Patients Under General Anesthesia Requiring Endotracheal Intubation Publisher

Summary: Can nasal dexamethasone reduce throat pain after surgery? A trial found stronger evidence for relief at six hours and early hoarseness, but no reliable dose-response pattern. #Anesthesia #Surgery

Shafa A ; Shetabi H ; Kheradmand Rad Z
Source: Journal of Isfahan Medical School Published:2026

Abstract

Background: Postoperative sore throat is a common complication following endotracheal intubation during general anesthesia. Dexamethasone has analgesic and anti-inflammatory properties. Building on a previous study of 8 mg intranasal dexamethasone, the present study simultaneously compared 6, 8, and 10 mg doses to examine between-dose differences and a possible dose-related pattern. Methods: This study included 100 patients who were candidates for ophthalmologic surgery. Participants were randomly divided into four groups of 25 patients. One group received 6 mg, one group received 8 mg, one group received 10 mg of intranasal dexamethasone, and one group received intranasal normal saline. Symptoms of sore throat, cough, and hoarseness were recorded after surgery and analyzed. The primary outcome was the incidence of postoperative sore throat; cough and hoarseness were secondary outcomes. Findings: No statistically significant between-group differences were observed in baseline demographic characteristics, tracheal-intubation-related variables, or duration of surgery. In unadjusted time-specific analyses, the dexamethasone groups had lower incidences of sore throat, cough, and hoarseness from recovery through 6 hours. In a sensitivity analysis applying Holm–Bonferroni correction to the 18 outcome-by-time tests, sore throat remained significant only at 6 hours (adjusted P = 0.028), hoarseness remained significant at the four early time points (adjusted P < 0.018), and no cough comparison remained significant. Conclusion: A decreasing percentage of sore-throat incidence was observed with increasing intranasal dexamethasone dose; however, a formal trend analysis across the three active doses did not remain significant after multiplicity correction and therefore does not establish a dose-response relationship. After conservative multiplicity adjustment, the more robust statistical evidence was mainly limited to sore throat at 6 hours and early postoperative hoarseness. These results should be interpreted cautiously because within-patient repeated measurements were not modeled longitudinally. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.