Expert: Dr Ian Jackson - please note UK based - 11/22/2006

Question
Lucky me as I get to have my second major surgery in a year and a half at the age of 26.  The last surgery I had was about seven hours, and I got a very severe sore throat from the intubation.  The sore throat was far more painful than the actual surgery.  I could not drink for about 12 hours after surgery.  My voice was also ruined (comically high pitched) for about five days.  Pain medication, IV or oral, seemed to do nothing for my sore throat, although it worked on my surgery pain.

My upcoming surgery is of about the exact same duration, but with a different surgeon and anaesthiaologist.  Fortunately, they also won't be working in my mouth and throat area, which they did for my first surgery.  However, I would still like to avoid any risk of this happening again.  My surgeon says general anaesthesia with intubation is the only option though, but he did say that he would keep the intubation and heavy anaesthesia to a minimum (about half the surgery).  Is there anything I can do or ask for to prevent or minimize this?  Is there anything I can ask the anaesthesiaologist to do (such as using a smaller breathing tube) as well?

Answer
Hi Roxanne
I am really sorry that you have to undergo further surgery. The important thing here is to explain to your anaesthetist what happened the last time and how distressing this was for you. A smaller breathing tube does not necessarily reduce the trauma to your trachea and voice box. If you explain the problem then there is a possibility that the anaesthetist might be able to look after you with an alternative airway device in your throat (called a laryngeal mask) that may cause less trauma. This does depend on the procedure you are having performed and so may not be possible.
However having pointed out the problem you had previously your anaesthetist should work very hard to ensure you do not have the same experience this time. We can use special tubes that minimise the risk of this happening for patients who are going to be intubated for a long time.
Sorry I cannot provide more information - all I can say is that if I or most of my colleagues were looking after you we would try very hard to do better for you this time!
Kind regards
Dr Ian Jackson