Comparative study between oral acetaminophen and lidocaine spray on endotracheal tube-related sore throat in adult intensive care

Background/Purpose: Endotracheal tube (ETT)-related sore throat is a common source of stress in intensive care. Quantitative studies on therapy for ETT-related sore throat remain limited. The current study evaluated the therapeutic effects of oral acetaminophen (ACT) and lidocaine (LIDO) spray on pain relief for ETT-related sore throat in intensive care.Methods: Patients who could communicate with caregivers non-verbally and who had acquired ETT-related sore throat at a medical intensive care unit (ICU) were enrolled. The medications were dispensed at the request of the patients. The intensity of ETT-related throat pain was recorded for quantitative comparison before and after patients received 500 mg of ACT orally or one dose of 10% LIDO spray locally. Before leaving the ICU, the patients were interviewed by a research nurse to assess the effect of these interventions on satisfaction with pain management for ETT-related sore throat. Results: We enrolled 89 patients during the study period, and the intensity of ETT-related throat pain significantly decreased after treatment (6.97 in 5 min before vs. 3.60 in 120 min after oral ACT, P < 0.001; 8.56 in 5 min before vs. 4.12 in 120 min after LIDO application, P < 0.001). The degree of pain reduction over time differed between the ACT and LIDO groups. Patients in the LIDO group made more requests for additional therapy compared with patients in the ACT group (1 LIDO spray per request for an average of 4.7 requests vs. 1 ACT dose per request for an average of 1.3 requests, P < 0.001). Patients in both the ACT and LIDO groups reported high satisfaction with pain management for ETT-related sore throat (87.3 of 100 vs. 86.5 of 100, respectively, P = 0.805).Conclusion: ACT and LIDO treatment can effectively attenuate ETT-related sore throat. Patients were highly satisfied with pain management for ETT-related sore throat after both oral ACT and local LIDO application.