Reducing the Incidence of Postoperative Sore Throat in Adult Surgical Patients

Abstract

Problem & Purpose: Postoperative sore throat is a recurrent complication following laryngeal mask airway use and leads to patient dissatisfaction, the need for additional pain medication, and increased length of stay. Up to 25% of surgical patients at a trauma level II hospital complain of postoperative sore throat after procedures requiring the use of a laryngeal mask airway device. Purpose: The purpose of the quality improvement project was to implement and monitor compliance of providers’ use of manometers intraoperatively. The practice change was implemented at this facility to help decrease the incidence of postoperative sore throat in adult surgical patients. Methods: After educating the anesthesia care team and post-anesthesia care unit registered nurses on postoperative sore throat, all eight operating rooms were equipped with the Posey cuff pressure manometers. Anesthesia providers measured cuff pressures intraoperatively to maintain the recommended pressure of less than 60 mmHg. Cuff pressures were then documented. The presence of postoperative sore throat was evaluated and documented by the post-anesthesia care unit registered nurses. Data was analyzed weekly via run charts over 14 weeks. Results: A total of 26 data points were collected. Weeks one through six lacks compliance data points then an upward trend in compliance occurred with a later decrease in compliance, averaging at 41.5% by week 14. Approximately, 92% percent of patients reported an absence of postoperative sore throat. Conclusions: The feasibility of this QI project is proven through successful implementation of LMA cuff pressures at less than 60 mmHg to decrease the incidence of POST. Promotion of practice change by change champions will aid in sustainability. There will be a slight change in work-flow of anesthesia providers with intraoperative use of LMA cuff pressure manometers.