Interventions
sore throat, throat, pain, cough, complaint, palate, agitation, NRS
SORE THROAT, BLIND
After the patient's admission to the operating room, routine monitoring of blood pressure, heart rate (HR), electrocardiogram (ECG), and pulse oxygen saturation (SpOI-gel insertion approach: the manufacturer's weight-based recommendations were followed for size selection. The size selection for i-gel was also considered in conjunction with clinical assessment of the patient’s anatomy. The patient was in the sniffing position with head extended and neck flexed. The doctor introduce the leading soft tip into the mouth with the direction towards the hard palate. Glide the device along the hard palate until a definitive resistance was felt. The insertion procedure was performed gently with slight adjustment in the mouth. The insertion was attempted once in all patients.After i-gel insertion, the neck was covered by gauze to blind the evaluators and patients. The covered gauze was not removed until the ending of the evaluation at 24 h after the surgery. After that, the attending anesthesia doctor who was in charge of general anesthesia was called to return to the operative room. Mechanical ventilation was performed with a controlled tidal volume of 6-8 ml/kg and respiratory rate of 12 per minute. Propofol, remifentanil, and sevoflurane inhalation (constant at MAC 0.7) were used to maintain anesthesia. Meanwhile bispectral index (BIS) monitoring was used for guiding anesthetic administration. Flurbiprofen axetil (50 mg) was given as postoperative analgesia.Voice recordings were obtained prior to anesthetic induction (0 h), 6 h and 24 h after surgery. Patients were inquired about the severity of the POST at 0.5 h, 6 h and 24 h after surgery. The intensity of POST was assessed with a quadrant scaling as follows: 0, no sore throat; 1, sore throat without complaint before inquiry; 2, sore throat with complaint; 3, severe sore throat and refusal to swallow. Sore throat was defined when POST grading > 1.Agitation was defined as the case who can not calm down even after verbal reminder. The intensity of cough was graded from 0 to 2. (0: none, 1: slight cough, 2: severe cough with body movement). The severity of cough and the incidence of agitation were recorded during the emergence time. The intensity of swallowing discomfort was recorded at 6 h after operations (NRS score: 0–10, 0: no pain, 10: the most severe pain and refusal to swallow). Anesthesiologist, patients, outcome assessors were blinded to the group allocation.