What spray is recommended for a patient with a dry, sore throat after extubation (removal of an endotracheal tube)?

From the FDA Drug Label

Directions Adults and children 2 years of age and older: apply to affected area using applicator tip use up to 4 times daily or as directed by a dentist or doctor The recommended spray for a patient with a dry, sore throat after extubation is benzocaine spray 1.

• Key points:
  • Apply to the affected area
  • Use up to 4 times daily or as directed by a dentist or doctor
  • Children under 12 years of age should be supervised in the use of this product
  • Children under 2 years of age: consult a dentist or doctor

From the Research

For a patient with a dry, sore throat after extubation, I recommend using benzydamine hydrochloride spray, as it has been shown to be the most effective in reducing the incidence and severity of postoperative sore throat 2. The use of benzydamine hydrochloride spray is supported by multiple studies, including a 2016 study published in the Brazilian journal of anesthesiology, which found that benzydamine hydrochloride gel on the endotracheal tube cuff is a simple and effective method to reduce the incidence and severity of postoperative sore throat 2. Some key points to consider when using benzydamine hydrochloride spray include:

• Apply the spray directly to the throat as needed, not exceeding the recommended dose
• Use supplementary measures such as sipping cool water frequently, using a humidifier, sucking on ice chips, and avoiding irritants like smoking to help alleviate symptoms
• The sore throat typically results from mechanical trauma to the pharyngeal and laryngeal tissues during intubation, along with mucosal drying from the endotracheal tube
• Most post-extubation sore throats resolve within 24-72 hours with symptomatic treatment, but if symptoms persist beyond 3-4 days or worsen, further evaluation is warranted to rule out complications. It's worth noting that other options, such as lidocaine 2% viscous solution, can be used as a gargle, but benzydamine hydrochloride spray has been shown to be more effective in reducing the incidence and severity of postoperative sore throat 3, 2.