Why Do I Have a Sore Throat After Surgery?

A sore throat after surgery is common, particularly if general anesthesia is used.

General anesthesia uses medications to put you into a sleep-like state during surgery so that you are unconscious and do not feel pain or move. It also requires a breathing tube that can irritate the throat.

After surgery with general anesthesia, many patients report throat discomfort ranging from mild to severe in the hours and days following their surgery. 

It is typically nothing to worry about unless it impacts the ability to speak or if the soreness lasts more than a week.

This article will explore the two leading causes of a sore throat after surgery, how to soothe it, and when to seek medical care.

Causes

Your throat probably hurts after surgery for one of two reasons: dehydration or irritation from methods to maintain your breathing. Sometimes, it may be due to both.

Dehydration

After surgery, you may be dehydrated, so your body does not have enough fluids to function at its best. This can cause dryness in your throat.

Dehydration can happen since you aren't allowed to eat or drink before surgery, and you may be allowed only minimal food and fluids after surgery. 

Drinking water and other fluids will relieve this problem.

Breathing Tubes

The anesthesia drugs used during general anesthesia paralyze your muscles, including the diaphragm, which keeps you breathing. This requires methods to maintain breathing during surgery.

It's common for an endotracheal tube to be put into your mouth and down your throat, a process called intubation.

This tube, which is inserted into your trachea or windpipe, is then attached to a ventilator to provide oxygen during surgery and potentially during the early stages of recovery.

Sometimes, face masks or laryngeal mask airways (LMA) are used. LMAs are devices with a tube that sits in the back of the throat above the opening to the trachea. These breathing tubes can also lead to throat dryness or irritation.

The procedure to insert the tube can be irritating to the throat, tongue, and vocal cords. In addition, having the tube remain in place can cause further irritation in the mouth and throat.

After the tube is removed, it's common for your mouth, throat, and airway to be sore, and you may experience burning and other symptoms.

If your condition requires a prolonged stay on the ventilator, the resulting sore throat may be more significant.

Most facilities will encourage a tracheostomy, which involves an incision into your neck to access your windpipe if the breathing tube and ventilator are necessary for more than 10-14 days. This is because leaving the breathing tube in place for too long can cause permanent damage to the vocal cords.

If you have other types of anesthesia that do not require breathing assistance, such as a regional block of sensation in a specific area of your body. In that case, you shouldn't experience throat discomfort.

How to Soothe a Sore Throat After Surgery

If you get throat soreness after surgery, various options can help ease the pain.

Some over-the-counter (OTC) remedies can be helpful. Numbing lozenges with benzocaine are particularly effective for this type of irritation. The medication coats and protects the throat while numbing the area. Sucking on hard candy can also help keep the area more lubricated to decrease pain.

It's also important to drink lots of fluids. This can help keep your throat moist and pain-free, and if tolerated, ice water can act like a cold pack for the inside of the throat. 

Some people prefer popsicles and other cold/icy treats but avoid citrus, such as orange or lemon, as they can irritate already tender tissues.

How Long Does a Sore Throat Last?

You might notice a sore throat immediately after waking up from surgery. However, you might not feel any throat pain initially because pain-relieving drugs might mask any discomfort in your throat. As medications wear off, you might start to notice a sore throat.

Irritation in your throat might last several days following surgery, depending on factors like the size of the endotracheal tube used during surgery, the duration of intubation, your level of hydration, and any pain medication you might be taking.

Usually, symptoms begin to ease after two to three days. At four days, many patients feel their throat has improved significantly, although it might take up to six days to resolve symptoms completely.

When to See a Healthcare Provider

Don't ignore a throat problem that isn't improving in the days following surgery. Within three to four days after surgery, most people report that their sore throat is no longer an issue and are back to eating and drinking without difficulty.

If your sore throat persists for more than a week or your voice is affected, contact your surgeon or another healthcare provider. You may be referred to an ENT (ear, nose, and throat) specialist called an otolaryngologist.

Permanent throat or vocal cord injury is rare, but it is one of the risks of anesthesia, and early treatment can make a dramatic difference in the outcome. 

Keep in mind that the sore throat may be unrelated to the surgery. For example, a person might also have an exposure that leads to an infection such as strep throat, a contagious bacterial infection that causes a sore throat. It may require antibiotics as treatment. Antibiotics kill or stop the growth of bacteria.

Summary

Post-surgical throat pain is common and can be due to dehydration or irritation from any tubes in your throat that keep you breathing during surgery.

The irritation usually improves in a few days and should be gone in about a week. You can manage it by drinking plenty of fluids, especially cold ones, and sucking on medicated lozenges or hard candy.