• Maria Calabrese, Gabriella Arlotta, Maria Enrica Antoniucci, Luca Montini, Diana Giannarelli, Temistocle Taccheri, Filippo Corsi, Stefano De Paulis, Andrea Scapigliati, Francesca Bevilacqua, Joel Vargas, Michele Corrado, Natalia Pavone, Piergiorgio Bruno, Massimo Massetti, and Franco Cavaliere.
• Department of Cardiovascular Sciences, Intensive Care Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
• J Clin Anesth. 2024 Mar 1; 95: 111418111418.

Study ObjectivePostoperative sore throat (POST) and hoarseness are common complications of tracheal intubation. This study aims to evaluate the efficacy of flurbiprofen administered through the subglottic port of tracheal tubes to prevent POST after cardiac surgery.DesignSingle-center, prospective, randomized, double-blind, placebo-controlled trial.SettingTertiary Care Referral University Hospital (Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome).PatientsIncluded 71 patients undergoing for elective cardiac surgery. Inclusion criteria were (a) age between 50 and 75 years, (b) NYHA class I or II, (c) surgery for myocardial revascularization or valve repair or replacement under cardiopulmonary bypass.InterventionPatients were double blind randomized to receive flurbiprofen or saline in the subglottic port of the endotracheal tube (groups F and P). The solution was injected ten minutes after tracheal tube placement, ten minutes after ICU admission and ten minutes before tracheal tube removal.MeasurementsThe primary outcome was to assess the effect of topical flurbiprofen administered through the subglottic port of the tracheal tube to prevent post-operative sore throat (POST). The secondary outcomes were the presence of hoarseness safety and patient's subjective satisfaction with their recovery. We did not report any exploratory outcomes.Main ResultsWe analyzed 68 patients, 34 patients in each group. In group F, two patients complained of POST and hoarseness (5.9%), while all controls did. The two groups significantly differed in the severity scores (VAS and TPS for sore throat and HOAR for hoarseness) at all time points. In group P, patients reported mild to moderate symptoms that significantly improved or disappeared 36 h after tracheal tube removal. According to the multivariable model, hoarseness affected women less than men, in the control group (p = 0.002). None of the patients in either group reported any adverse effects.ConclusionsRepeated administration of flurbiprofen through the subglottic port of tracheal tubes reduced the incidence of sore throat and hoarseness after cardiac surgery without evidence of complications.Copyright © 2024 Elsevier Inc. All rights reserved.

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