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Internal branch of superior laryngeal nerve block by dexamethasone alleviates sore throat after thyroidectomy: a randomized controlled trial

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Abstract

Purpose

Postoperative sore throat (POST) is a common complaint following thyroidectomy. Dexamethasone was reported to alleviate POST when administered via different routes. This study aimed to compare the effects of local spray and perineural injection surrounding the internal branch of superior laryngeal nerve (iSLN) in preventing POST and alleviating postoperative impaired voice function.

Methods

A randomized, double-blinded, controlled trial was performed to test the efficacy of the iSLN block in inhibiting of POST. A total of 161 patients who underwent elective thyroidectomy were randomly allocated to two groups. Group Spray: 4 mg dexamethasone was sprayed on to the vocal cord; Group iSLN: bilateral perineural injection with 4 mg dexamethasone around the iSLN. The incidence and severity of POST, swallowing pain, and its side effects were evaluated. Postoperative acoustic analysis, including jitter and shimmer, was also performed.

Results

Group iSLN exhibited a significantly less incidence and intensity of POST at 6 h and 24 h (P < 0.001). The patients experienced less swallowing pain at 6 h (P < 0.001) after the surgery, compared with Group Spray. When compared with Group Spray, Group iSLN improved postoperative voice function, which was characterized by lower jitter and lower shimmer value at 6 h and 24 h (P < 0.001) after the surgery. The severity of postoperative cough is higher in Group Spray (P < 0.001).

Conclusions

Among patients undergoing elective thyroidectomy, those who received perineural injection surrounding iSLN with dexamethasone had improved voice function and presented with more excellence in the inhibition of POST and cough, in comparison with the local spray.

Register information

This trial was registered in the Chinese Clinical Trial Registry on 4th Jan, 2021 (ChiCTR2100042145). The trial is registered at http://www.chictr.org.cn/showproj.aspx?proj=120142.

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The data was uploaded as a supplementary file.

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Funding

This research was funded by a grant from the Zhejiang Provincial Natural Science Funding [LY20H090008]; Zhejiang Provincial Health Commission Funding [2021KY788] and Wenzhou Municipal Science and Technology Bureau [Y20210130].

Author information

Author notes

  1. Yushi Jin, Xiaotian Zhou and Xiaodan Chen contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Anesthesiology, 1st Affiliated Hospital, Wenzhou Medical University, Wenzhou, China

    Yushi Jin, Xiaotian Zhou, Jinxia Cai, Qimin Zhao, Xinyi Huang, Yizhao Pan & Jiehao Sun

  2. Operative Room Nursing, 1st Affiliated Hospital, Wenzhou Medical University, Wenzhou, China

    Xiaodan Chen

Authors
  1. Yushi Jin
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  2. Xiaotian Zhou
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JY, ZX, CX. Original draft was written by JY and SJ and all authors commented on previous versions of the manuscript.

Corresponding author

Correspondence to Jiehao Sun.

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Conflict of interest

The authors have no relevant financial or nonfinancial interests to disclose.

Ethics approval

Ethical approval for the study (Ethical Committee No. 2020-135.) was provided by the Institutional Research Ethics Committee of the 1st affiliated hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (Chairman: Professor Gaojun Wu) on 15th Sep, 2020.

Consent

Informed written consent was obtained before the study from every patient.

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Jin, Y., Zhou, X., Chen, X. et al. Internal branch of superior laryngeal nerve block by dexamethasone alleviates sore throat after thyroidectomy: a randomized controlled trial. Eur Arch Otorhinolaryngol 279, 5877–5884 (2022). https://doi.org/10.1007/s00405-022-07513-5

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  • DOI: https://doi.org/10.1007/s00405-022-07513-5

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