Effect of Preoperative Nebulized Dexmedetomidine, Ketamine, and Magnesium Sulphate on Postoperative Sore Throat in Laparoscopic Surgery: A Randomized Double-Blind Trial

Background: Postoperative sore throat (POST) remains one of the most common complications following endotracheal intubation under general anaesthesia, with an incidence ranging from 21% to 65%. It results from mechanical trauma, mucosal ischemia, inflammation, and nociceptive activation during airway instrumentation. Various pharmacological strategies have been explored to mitigate POST, among which preoperative nebulization offers a simple, non-invasive, and effective approach. Agents such as dexmedetomidine, ketamine, and magnesium sulphate possess anti-inflammatory, analgesic, and NMDA receptor-modulating properties that may reduce airway irritation and postoperative discomfort. Objective: To compare the efficacy of nebulized dexmedetomidine, ketamine, and magnesium sulphate in preventing postoperative sore throat in patients undergoing elective laparoscopic surgeries under general anaesthesia. Methods: This randomized, double-blind study included 135 adult patients divided equally into three groups (n=45 each). Group D received dexmedetomidine nebulization, Group K received ketamine, and Group M received magnesium sulphate prior to induction. POST incidence and severity were assessed at 0, 2, 6, 12, and 24 hours postoperatively. Hemodynamic parameters and adverse effects were also recorded. Results: Dexmedetomidine significantly reduced both incidence and severity of POST compared to ketamine and magnesium sulphate (p<0.05). Magnesium sulphate showed the highest incidence of POST. Hemodynamic stability was superior in dexmedetomidine group, although higher sedation and bradycardia were observed. Conclusion: Preoperative nebulized dexmedetomidine is more effective than ketamine and magnesium sulphate in reducing POST, making it a preferable agent in clinical practice.