The Effect of Early Cold Steam Application and Ice Pieces Impregnation on Sore Throat and Hoarseness Due to Intubation on Patients Undergoing General Anesthesia

The study was planned to identify the effect of early cold steam application and ice pieces impregnation on sore throat and hoarseness due to intubation on patients undergoing general anesthesia. This is a randomized controlled experimental study. It was conducted in Adnan Menderes University Research and Application Hospital General Surgery Clinic between April 1st 2017 - April 1st 2018. In the study, patients to be included in control and treatment groups were determined by randomization method. Groups were comprised of control group, cold steam group, ice pieces impregnated group, cold steam with ice pieces impregnated group. 30 in each group totally 120 people were included in the study. Data collection forms, ASA (American Society of Anesthesiologists) classification, mallampati scoring, patient identification form, Ramsay Sedation Scale, VAS (Visual Analogue Scale) and Stout's hoarseness evaluation form were used to collect the data. Cold steam was both applied to the patients in the application groups in the second hour after the operation and to the cold steam application group for 15 minutes and their sore throat and hoarseness were evaluated before and after the application of cold steam. No application was made to ice-impregnated group and cold steam with ice pieces impregnated group. They were just evaluated in terms of sore throat and hoarseness. Sore throat and hoarseness of the patients in the treatment group were evaluated at the postoperative sixth hour before the application. The cold steam was applied to the cold steam group for 15 minutes, ice pieces were impregnated to ice impregnated group, cold steam was applied to cold steam with the ice pieces impregnated group for 15 minutes and then they were impregnated ice pieces. Sore throat and hoarseness were reevaluated at the 6th hour after the application in all treatment groups. In the 0th 24th hour postoperative period, no application was made to the treatment groups and they were only evaluated in terms of sore throat and hoarseness. The patients in the control group did not undergo any procedure or intervention but their sore throat and hoarseness were evaluated at the postoperative 0th, 2nd, 6th and 24th hours. The data obtained from the research were analyzed by computer and SPSS statistical package program (Version 15, Chicago IL, USA). In the analysis of the data collected for the purpose of the research; Percentage, Pearson Chi-Square, One-Way ANOVA, Analysis of Variance, Student-t Test and Cochran's Q, Mc Namer Test, Friedman Test, Bonferroni Test, Fisher's Exact Test were used. Statistical significance level was given as (p <0.05). When the mean age, BMI (Body Mass Index), gender, marital status, education level, smoking status, presence of chronic disease and history of surgery were examined, no statistical significant difference was found between the groups (p >0.05). The mean pain (VAS) score of the patients who had cold steam application at the postoperative 2nd hour was 4.40 ± 1.78 before the application and 2.86 ± 1.80 after the application. The mean postoperative pain (VAS) score of the patients who had cold steam application was significantly lower than the pre - treatment (p <0.05). The mean post application pain (VAS) scores of the patients who were treated with cold steam at the 6th hours postoperatively, ice impregnated group, cold steam with ice pieces impregnated group were significantly lower than the pre-application (p <0.05) . It was found out that postoperative pain (VAS) score at the 6th hour after the application decreased in all groups but there was no significant difference between the groups in terms of mean pain (VAS) scores (p> 0.05). It was determined that postoperative hoarseness decreased in all groups in time but there was no significant difference between the groups (p> 0.05). As a result of this study it could be concluded that cold application was effective in reducing sore throat but had no effect on hoarseness. Key Words: Endotracheal Intubation, Sore Throat, Hoarseness, Cold Steam, Ice Application, Nursing