Effect of intraoperative use of muscle relaxants on postoperative pharyngeal discomfort after intubation anesthesia: a systematic review and meta-analysis

Abstract Background General anesthesia with intubation is widely used for surgery. The factors responsible for pharyngeal discomfort after intubation need to be identified. This meta-analysis aimed to clarify the relationship between intraoperative use of muscle relaxants and postoperative pharyngeal discomfort in patients, which is important for postoperative perioperative care. Methods Publications in English were manually searched. After evaluating the quality of selected studies, a meta-analysis was conducted using Review Manager 5.4 software and Endnote. Three reviewers independently selected the data from the selected studies. Results In the included literatures, muscle relaxants were used in the experimental group and normal saline was used in the control group. Ten randomized controlled trials (with a total of 1358 patients) were included in this meta-analysis. The risk of pharyngalgia and cough was lower in patients receiving muscle relaxants than in controls (RR = 0.67, 95% CI: 0.53 to 0.86, P = 0.002; RR = 0.053, 95% CI: 0.007 to 0.381, P = 0.004). Risk of sore throat, and hoarseness were not significantly different between those receiving muscle relaxants and controls (RR = 0.92, 95% CI: 0.68 to 1.23, P = 0.65; RR = 1.01, 95% CI: 0.81 to 1.27, P = 0.92). The preoperative first pass success was significantly higher in patients receiving muscle relaxants than in control patients (RR = 0.37, 95% CI: 0.14 to 0.98, P = 0.05). Conclusion The use of muscle relaxants during intubation anesthesia effectively reduced the development of upper respiratory complications, which also ruled out a negative effect of muscle relaxants in some patients with postoperative upper respiratory complications; however, the incidence of postoperative sore throat and hoarseness was quite high. However, the incidence of postoperative sore throat and hoarseness is quite high and requires continued exploration