Topical benzydamine for preventing postoperative sore throat. A reply

We appreciate Singh et al.'s thoughtful comments about our systematic review examining the efficacy of topical benzydamine hydrochloride for preventing postoperative sore throat in adults 1. Firstly, we share the common concern that intubation with a double-lumen tube may increase the incidence and severity of postoperative sore throat. Although not shown in our article, sub-group analysis confirmed that benzydamine hydrochloride prevents postoperative sore throat (risk ratio [RR] 0.38; 95%CI 0.19–0.77) and mitigates its severity (standardised mean difference [SMD] −0.50; 95%CI −0.91 to −0.08) in patients whose tracheas are intubated with double-lumen tubes 2. Benzydamine hydrochloride also prevents postoperative sore throat (RR 0.28; 95%CI 0.17–0.47) and mitigates its severity (SMD −0.24; 95%CI, −0.66 to 0.19) in the other sub-group. Singh et al. suggested that the incidence of postoperative sore throat that we used was different to that reported by Nimmaanrat et al. 3, who stated that 25 patients (58.1%) from each group experienced postoperative sore throat, without specifying the time point they examined. We obtained the unpublished data from these authors, which we pooled into our analysis. We reaffirm, therefore, that topical benzydamine hydrochloride prevents postoperative sore throat.