Postoperative Sore Throat after Endotracheal Intubation: Empirical Evidence of the Incidence and Risk Factors

Authors

  • Muhammad Umair Arif Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan.
  • Tooba Rana Senior Demonstrator, Biochemistry Department, Allama Iqbal Medical College, Lahore, Pakistan.
  • Muhammad Adeel Khan Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan.
  • Qandeel Younas Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan.
  • Muhammad Nabeel Khan Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan.
  • Waqas Akram Assistant Professor. Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan.

DOI:

https://doi.org/10.59644/oaphhar.4(2).280

Keywords:

Airway Complicatons, Endotracheal Intubation, Endotracheal Tube (ETT), General Anesthesia, Perioperative Care, Postoperative Sore Throat (POST)

Abstract

 The present study aims to find the incidence, severity, and risk factors for sore throat after surgery performed under general anesthesia with endotracheal intubation. A cross-sectional study involving 214 patients aged≥ 10 years in a tertiary care hospital. Patients with a history of sore throat or upper respiratory infection and/or at high risk for difficult intubation were excluded. Normal anesthetic procedure employed. Demographic data, endotracheal tube (ETT) size, and duration of anesthesia were gathered as well as intubation-related factors. 13% of the patients had some post-symptoms, and most of them (86.9%) had none. Of affected patients, 5.1% had mild and 7.9% had moderate symptoms; none had severe symptoms. POST was most reported at the 4th postoperative hour. Although larger ETT sizes and longer anesthesia duration showed higher odds of POST, no statistically significant association was found with age, gender, BMI, ASA classification, or urgency of surgery (p > 0.05). POST incidence in this study was relatively low compared to existing literature, with most cases being mild and self-limiting. Effective airway management and adherence to standardized anesthetic techniques play a key role in reducing POST.

Author Biography

Tooba Rana, Senior Demonstrator, Biochemistry Department, Allama Iqbal Medical College, Lahore, Pakistan.

Senior Demonstrator Biochemistry Department Allama Iqbal Medical Lahore

References

Lee, J. Y., Sim, W. S., Kim, E. S., Lee, S. M., Kim, D. K., Na, Y. R., ... & Park, H. J. (2017). Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients. Journal of International Medical Research, 45(2), 744-752. DOI: https://doi.org/10.1177/0300060516687227

Chang, J. E., Kim, H., Han, S. H., Lee, J. M., Ji, S., & Hwang, J. Y. (2017). Effect of endotracheal tube cuff shape on postoperative sore throat after endotracheal intubation. Anesthesia & Analgesia, 125(4), 1240-1245. DOI: https://doi.org/10.1213/ANE.0000000000001933

. Maria Jaensson, R. N. A., Anil Gupta, M. D., & Ulrica, G. N. R. (2012). Risk factors for development of postoperative sore throat and hoarseness after endotracheal intubation in women: a secondary analysis. AANA journal, 80(4), S67.

Bekele, Z., & Melese, Z. (2023). Incidence and risk factors for postoperative sore throat after general anesthesia with endotracheal intubation: prospective cohort study. Annals of Medicine and Surgery, 85(6), 2356-2361. DOI: https://doi.org/10.1097/MS9.0000000000000786

Rajkumar, G., Eshwori, L., Konyak, P. Y., Singh, L. D., Singh, T. R., & Rani, M. B. (2012). Prophylactic ketamine gargle to reduce post-operative sore throat following endotracheal intubation. Journal of medical society, 26(3), 175-179. DOI: https://doi.org/10.4103/0972-4958.113242

Chen, Z., Zuo, Z., Zhang, L., Gong, M., Ye, Y., Jin, Y., & Zhao, X. (2025). Postoperative sore throat after tracheal intubation: an updated narrative review and call for action. Journal of Pain Research, 2285-2306. DOI: https://doi.org/10.2147/JPR.S498933

Jaensson, M., Olowsson, L. L., & Nilsson, U. (2010). Endotracheal tube size and sore throat following surgery: a randomized‐controlled study. Acta Anaesthesiologica Scandinavica, 54(2), 147-153. DOI: https://doi.org/10.1111/j.1399-6576.2009.02166.x

Bennett, M. H., Isert, P. R., & Cumming, R. G. (2000). Postoperative sore throat and hoarseness following tracheal intubation using air or saline to inflate the cuff—a randomized controlled trial. Anaesthesia and intensive care, 28(4), 408-413. DOI: https://doi.org/10.1177/0310057X0002800409

Obsa, M. S., Adem, A. O., Bancha, B., Gelgelu, T. B., Gemechu, A. D., Tilla, M., ... & Abdulkadir, S. (2022). Global incidence and risk factors of post-operative sore throat among patients who underwent surgery: a systematic review and meta-analysis. International Journal of Surgery Open, 47, 100536. DOI: https://doi.org/10.1016/j.ijso.2022.100536

Gauchan, S., Thapa, C., Yadav, R., & Bhandari, S. (2024). Postoperative sore throat among patients following general anesthesia with endotracheal intubation in a tertiary care centre. JNMA: Journal of the Nepal Medical Association, 62(269), 1. DOI: https://doi.org/10.31729/jnma.8399

Seet, E., Yousaf, F., Gupta, S., Subramanyam, R., Wong, D. T., & Chung, F. (2010). Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology, 112(3), 652-657. DOI: https://doi.org/10.1097/ALN.0b013e3181cf4346

SHAH, M., & MAPLESON, W. (1985). Sore Throat After Intubation of the Trachea. Survey of Anesthesiology, 29(5), 275-276. DOI: https://doi.org/10.1097/00132586-198510000-00026

Hu, B., Bao, R., Wang, X., Liu, S., Tao, T., Xie, Q., ... & Deng, X. (2013). The size of endotracheal tube and sore throat after surgery: a systematic review and meta-analysis. PloS one, 8(10), e74467. DOI: https://doi.org/10.1371/journal.pone.0074467

Andrea, L. B., Baker, K. S., & Terri, J. (2011). Factors affecting the incidence of sore throat following general anesthesia with endotracheal tube versus laryngeal mask airway. School Nur Anesthes, Texas Christ Uni, 14(1), 888.

Zuccherelli, L. (2003). Postoperative upper airway problems. Southern African Journal of Anaesthesia and Analgesia, 9(2), 12-16. DOI: https://doi.org/10.1080/22201173.2003.10873000

Birhanu Mengistu, S., & Akalu, L. (2017). Magnitude and associated risk factors of post-operative sore throat following surgery by general anesthesia with endotracheal intubation in Black Lion Hospital, Addis Ababa, Ethiopia. Int J Anesthesiol Res, 5(2), 409e13. DOI: https://doi.org/10.19070/2332-2780-1700084

McHardy, F. E., & Chung, F. (1999). Postoperative sore throat: cause, prevention and treatment. Anaesthesia, 54(5), 444-453. DOI: https://doi.org/10.1046/j.1365-2044.1999.00780.x

Kolawole, I. K., & Ishaq, M. S. (2008). Post-anaesthetic respiratory complaints following endotracheal anaesthesia in lower abdominal obstetric and gynaecology surgery. Nigerian journal of clinical practice, 11(3), 225-230.

Joh, S., Matsuura, H., Kotani, Y., Sugiyama, K., Hirota, Y., Kiyomitsu, Y., & Kubota, Y. (1987). Change in tracheal blood flow during endotracheal intubation. Acta anaesthesiologica scandinavica, 31(4), 300-304. DOI: https://doi.org/10.1111/j.1399-6576.1987.tb02571.x

Higgins, P. P., Chung, F., & Mezei, G. (2002). Postoperative sore throat after ambulatory surgery. British journal of anaesthesia, 88(4), 582-584. DOI: https://doi.org/10.1093/bja/88.4.582

Lehmann, M., Monte, K., Barach, P., & Kindler, C. H. (2010). Postoperative patient complaints: a prospective interview study of 12,276 patients. Journal of clinical anesthesia, 22(1), 13-21. DOI: https://doi.org/10.1016/j.jclinane.2009.02.015

NAVARRO, R. M., & BAUGHMAN, V. L. (1998). Lidocaine in the Endotracheal Tube Cuff Reduces Postoperative Sore Throat. Survey of Anesthesiology, 42(5), 292. DOI: https://doi.org/10.1097/00132586-199810000-00045

Tanaka, Y., Nakayama, T., Nishimori, M., Sato, Y., & Furuya, H. (2009). Lidocaine for preventing postoperative sore throat. Cochrane database of systematic reviews, (3). DOI: https://doi.org/10.1002/14651858.CD004081.pub2

Fenta, E., Teshome, D., Melaku, D., & Tesfaw, A. (2020). Incidence and factors associated with postoperative sore throat for patients undergoing surgery under general anesthesia with endotracheal intubation at Debre Tabor General Hospital, North central Ethiopia: A cross-sectional study. International Journal of Surgery Open, 25, 1-5. DOI: https://doi.org/10.1016/j.ijso.2020.06.003

Farhang, B., & Grondin, L. (2018). The effect of zinc lozenge on postoperative sore throat: a prospective randomized, double-blinded, placebo-controlled study. Anesthesia & Analgesia, 126(1), 78-83. DOI: https://doi.org/10.1213/ANE.0000000000002494

Gemechu, B. M., Gebremedhn, E. G., & Melkie, T. B. (2017). Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014. The Pan African Medical Journal, 27, 127. DOI: https://doi.org/10.11604/pamj.2017.27.127.10566

Published

2026-06-05

How to Cite

1.
Muhammad Umair Arif, Tooba Rana, Muhammad Adeel Khan, Qandeel Younas, Muhammad Nabeel Khan, Waqas Akram. Postoperative Sore Throat after Endotracheal Intubation: Empirical Evidence of the Incidence and Risk Factors . OAPH&HAR [Internet]. 2026 Jun. 5 [cited 2026 Jun. 9];4(2):125-34. Available from: https://journal.mdpip.com/index.php/oapr/article/view/280