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The Effect of Zinc Lozenge on Postoperative Sore Throat: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study

Farhang, Borzoo, DO; Grondin, Lydia, MD

doi: 10.1213/ANE.0000000000002494
Anesthetic Clinical Pharmacology: Original Clinical Research Report

BACKGROUND: Postoperative sore throat (POST) is commonly seen after endotracheal intubation, and oral zinc prevents oral mucositis associated with chemotherapy. This study is designed to evaluate the effects of administration of zinc lozenges on POST.

METHODS: Seventy-nine patients undergoing low- or moderate-risk surgery with endotracheal intubation were randomly assigned into 2 groups: Control group received placebo and zinc group received 40-mg zinc lozenges 30 minutes preoperatively. Patients were assessed for incidence and severity (4-point scale, 0–3) of POST at 0, 2, 4, and 24 hours postoperatively. The primary outcome was incidence of POST at 4 hours after surgery. The secondary outcomes were the incidence of POST at 0, 2, and 24 hours and the severity of POST.

RESULTS: At 4 hours, there was a significantly lower incidence of POST in the zinc group, 7%, than the control group, 29% (P = .046). The incidence of POST at 0 hour was 0% in zinc group and 24% in control group (P = .004). The highest incidence of POST occurred at the second hour after surgery, with the rate of 10% in the zinc group and 34% in the control group (P = .0495). The incidence of POST at 24 hours was 13% in zinc group and 24% in control group (not significant). The severity of POST was significantly lower in the zinc group for mild (P = .003) and moderate (P = .004) POST.

CONCLUSIONS: The administration of a single dose of 40-mg zinc lozenge 30 minutes preoperatively is effective to reduce both incidence of POST in the first 4 hours and severity of mild and moderate POST in the immediate postoperative period.

Published ahead of print September 25, 2017.

From the Department of Anesthesiology, University of Vermont College of Medicine, Burlington, Vermont.

Published ahead of print September 25, 2017.

Accepted for publication August 15, 2017.

Funding: University of Vermont, Department of Anesthesiology Grant.

The authors declare no conflicts of interest.

Clinical Trial Number: Identifier: NCT02405832, Principal Investigator: Lydia Grondin; Registered: March 27, 2015; Last verified: April 2015.

Reprints will not be available from the authors.

Address correspondence to Borzoo Farhang, DO, Department of Anesthesiology, University of Vermont Medical Center, 111, Colchester Ave, Burlington, VT 05401. Address e-mail to

© 2018 International Anesthesia Research Society
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