Observational study on the application of different esketamine gargle doses for the prevention of postoperative sore throat after laryngeal mask airway insertion
In brief
25 mg esketamine gargle cuts sore throat after LMA insertion from one-third to one-tenth
In a randomized trial of 150 adults, a single 25 mg esketamine gargle given before anesthesia lowered the 2-hour postoperative sore-throat rate to 10% versus 32% with saline, while higher 50 mg dosing offered no extra benefit. The intervention was safe, suggesting a simple prophylaxis for LMA-related discomfort.
- Journal
- Frontiers in pharmacology (Q1)
- Published
- 7 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Le Bo, Yi Chen, Linsen Sun, Peng Zhai, Yan Jiang, Xiaoxiao Xu, et al.
- PMID
- 42630542
- DOI
- 10.3389/fphar.2026.1882856
Why clinicians should know about it
- Picked for Otorhinolaryngology (top studies of the week, 23 August 2026): Esketamine gargle RCT, prevents postoperative sore throat
Abstract
BACKGROUND: Ketamine gargle is considered a highly effective measure for preventing postoperative sore throat (POST). This randomized controlled study aimed to explore the efficacy, safety, and optimal dosage of esketamine gargle for preventing POST following laryngeal mask airway insertion. METHODS: A total of 150 patients were randomly assigned to receive normal saline (NS), 25 mg, or 50 mg of esketamine gargle at a 1:1:1 ratio for 30 s prior to general anesthesia. The primary outcomes were the incidence of POST at 2, 6, and 24 h postoperatively. The secondary outcomes included the severity of POST at 2, 6, and 24 h postoperatively, along with the incidence and severity of dysphagia and hoarseness. Other outcomes included the incidence of the first intubation attempt, repositioning during surgery, convert to tracheal intubation, SpO2 < 90%, blood stain on the laryngeal mask airway, tachycardia and hypertension following gargling, intraoperative peak airway pressure, and end - tidal carbon dioxide partial pressure (PetCO2). RESULTS: The incidence of POST at 2, 6, and 24 h postoperatively was 32%, 10%, and 12%; 22%, 8%, and 8%; and 12%, 6%, and 4%, respectively, with a statistically significant difference among groups at 2 h postoperatively (P = 0.007). In comparison with the NS group, the incidence of POST at 2 h postopertively in the 25 mg group was significantly lower (32% vs. 10%, P = 0.013). No statistically significant differences were observed in the remaining outcomes. CONCLUSION: Esketamine gargle is effective and safe for preventing POST following laryngeal mask airway insertion, and a dose of 25 mg is recommended. CLINICAL TRIAL REGISTRATION: ChiCTR2500099787.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.