Pre-Operative Nebulization Strategies for the Prevention of Post-Operative Sore Throat in Patients Undergoing General Anesthesia: A Narrative Mini-Review of Pharmacological Interventions

Abstract

  Post-operative sore throat (POST) remains a common and distressing complication following general anesthesia with endotracheal intubation, adversely affecting patient comfort and satisfaction despite being considered minor. Its multifactorial pathophysiology—driven by airway mucosal trauma, inflammation, and neurogenic irritation—has prompted increasing interest in preventive rather than symptomatic strategies. Pre-operative nebulization has emerged as a simple, non-invasive, and targeted modality for airway protection. This narrative review synthesizes available evidence on pharmacological agents used as pre-operative nebulization for the prevention of POST, with particular emphasis on dexmedetomidine, ketamine, and magnesium sulphate. Data from randomized controlled trials, comparative studies, and meta-analyses are discussed to evaluate efficacy, mechanisms of action, safety, and clinical applicability. Additional nebulized and topical agents, including corticosteroids, local anesthetics, and herbal preparations, are also reviewed for contextual comparison. Overall, current evidence supports pre-operative nebulization as an effective prophylactic strategy against POST, with certain agents demonstrating consistent reductions in incidence and severity.