Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis
Preoperative intravenous dexamethasone prevents tracheal intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis.
Why is this relevant?
Sore throat following endotracheal intubation is common (reported in up to 68%), and along with postoperative nausea & vomiting, negatively impacts postoperative well-being.
Small studies have previously suggested that IV dexamethasone reduces sore throat due to intubation. It is thought this occurs by reducing mucosal inflammation at the point of tracheal cuff contact, the presumed aetiology of the majority of post-ETT sore throat.
Kuriyama and Maeda conducted a systematic review and meta-analysis of 15 RCTs totalling 1,849 patients.
And they found?
Preoperative dexamethasone IV (~4-10 mg across the studies) reduced the incidence of sore throat by almost 40% (RR 95% CI 0.51-0.75) and mean severity by 1.1 (SMD 95% CI 1.8-0.3).
Take-home...
Given the established effectiveness of preoperative dexamethasone to safely reduce post-operative nausea and vomiting, this meta-analysis affirms another important indication for the routine use of dexamethasone in intubated patients who do not have contraindications to steroid use.
summary -
In a national cross-sectional survey, we aimed to i) characterize work profile, workload, and income, ii) evaluate work satisfaction, work-life integration, burnout, incivility, mentorship, and promotion, iii) gauge future physician resource requirements, and iv) assess for differences by gender and specialty (adult vs pediatric). ⋯ Although most intensivists were satisfied with their careers, many were dissatisfied with their workload, experienced work-life integration challenges, and acknowledged burnout symptoms. Women intensivists were significantly less satisfied with their careers, experienced greater work-life integration challenges, more frequent and severe burnout symptoms, and greater incivility.