Sore throat is a common complain that most of the patients suffer. Anyone who have had surgery under anesthesia could have problems with dry sore throat. Soreness can be caused by a lot of things, and the cause can be the exact procedure or dehydration even before the surgery. During the surgery, anesthesiologist use laryngoscope to insert the endotracheal tube inside the trachea to perform endotracheal intubation. Also using laryngeal mask can cause soreness and some other effects. Here are some examples.
“In 5264 patients, 12.1% reported a sore throat. Patients with tracheal tube had the greatest incidence, 45.4%, followed by patients with laryngeal mask airway, 17.5%, while patients with a facemask had a lower incidence of sore throat, 3.3%. Female patients had more sore throats than male patients (13.4 vs. 9.1%). Airway management had the strongest influence on the incidence of sore throat. Sore throat in ambulatory surgical patients was associated with female sex, younger patients, use of succinylcholine, and gynaecological surgery.”
What Is The Main Cause For Sore Throat After Surgery?
- Because most of the patients are told not to drink and eat for some time before surgery, dryness of the mouth and throat is further enhanced by lack of water and it can be more susceptible to injuries.
- Endotracheal tube. It is the most common reason and it depends on a lot of factors, such as anesthesiologist expertise, tube diameter, using lubricating jelly, shortness of the neck, small jaw, prominent teeth, which are the main cause if the doctor doesn’t have a clear vision of the larynx.
- Laryngeal Mask Airway (LMA). It happens also, but not as often as endotracheal tube. It can be also because of differences in skills and techniques that anesthetist use, and also lubricants and cuff pressure.
- Guedel Airway or Mask Airway. The damage is less, since the oropharyngeal airway doesn’t come into the contact with the posterior wall of pharynx.
There are not many studies that show differences between these techniques, but there is a study that divided the “sore throat” into several, more precise symptoms: sore throat (continuous throat pain), dysphonia (changing of the voice), dysphagia (difficulty in swallowing) and pharyngeal dryness. 
Laryngeal Mask Airway (LMA)
This method of anesthesia is used to perform surgery outside the body cavities. It is made out of the airway tube which ends with soft elliptical mask and a cuff which is inserted trough the patients mouth down the windpipe and seal on the top of the glottis (unlike tracheal tube which pass through the glottis) keeping the airway clear. It can be used for inserting the oxygen or anesthesia gas to the lungs of the patient. It was invented in the early 1980. by Archibald Brain, a British anesthesiologist. It is important that the LMA is inserted properly and using the right size of the tube, and not overinflate the cuff. The cuff should be inflated to the right amount of pressure, since this is important too.
Tracheal intubation uses rubber flexible tube to insert into the trachea and provide the airway to the lungs. Usually, before the insertion of the tube, the patient goes for pre-medication for some muscle relief medications, sedatives and anesthesia, since most of the patients are unconscious while this procedure is being done. Once asleep, an anesthesiologist uses this instrument called laryngoscope with light at the end and insert it inside your mouth. When the vocal cords have been spotted, the tube is inserted inside the trachea and down through your vocal cords. In some cases, the tube can be attached to a machine for mechanical ventilation if the patient is not capable of breathing by himself. There are some risks in intubation, which are rare. Some of them are: bleeding, collapse of the lungs, infection or tearing of the soft tissue.
Dealing With Sore Throat After Surgery
All of this symptoms are normal and subside in three to seven days, even without any medication. If those symptoms get worse and your throat starts to swollen, if you experience the swelling of your face, neck pain, chest pain, you should seek medical attention for more help. Here are some thing that can help you:
- Warm drinks. Drinking warm tea or adding honey to it can help soothe your throat and add a good layer of protection and the honey is considered to be antibacterial so it will also keep you healthy.
- Speaking restriction. When you’re still freshly awaken and your vocal chords hurt, the best medicine is to keep it quiet. Spare your voice for some time till you feel better. Don’t even whisper, that still doesn’t help.
- Over-the-counter medicines. You can try using lozenges and chloraseptic sprays that are also effective to numb and relief the pain. You can also try with paracetamol (acetominophen) and aspirin.
Other Side Effects Of Anesthesia
Other than sore throat, there are some other complaints of the patients that went under anesthesia. The most common ones are vomiting and nausea. Also, muscle pain, disorientation, hair loss, hoarseness, hallucinations, cough, anxiety etc.
Postoperative nausea and vomiting (PONV) occurs in 24-48h after the surgery. It is the most common one with incidence of 30% in all post-surgical patients. The physiology of PONV is complex and it can be triggered by several stimuli, such as opioids, anesthetics, drug reactions, and motion. No antiemetic can reduce vomiting to zero. There are three types of antiemetics: serotonine antagonists, dopamin antagonists and corticosteroids.
Waking Up While Under Anesthesia
It happens that one or two people in 10,000 wake up during the surgery and experience what is called unintended intraoperative awareness. During that time, people are aware of the surrounding but are not feeling any pain. Because they are given the muscle relaxation medications, they can’t move or tell the doctors they are awake or experiencing any pain. For some patients this can be very traumatic and cause post -traumatic stress disorder. It is hard to find the cause, but it can be due to daily alcohol use, heart or lungs problems, long usage of drugs, lower dosage of anesthesia during operation and errors by the anesthesiologist.
 Rieger A, Brunne B, Hass I, et al. Laryngo-pharyngeal complaints following laryngeal mask airway and endotracheal intubation. Journal of Clinical Anesthesia 1997; 9: 42–7