Why Does My Throat Hurt After Surgery?

operating room
Joos Mind/Stone

A sore throat after surgery is surprisingly common and isn't alarming unless the ability to speak has been impacted.  A sore throat is considered a normal and expected issue after surgery. 

Most patients who have general anesthesia will report throat discomfort ranging from mild to severe in the hours and days following their surgery.  Patients who have other types of anesthesia, such as a regional block, twilight sedation or spinal anesthesia do not experience this type of throat discomfort.


Causes of Sore Throat After Surgery

Your throat probably hurts after surgery for one of two reasons:

First, you may be dehydrated since you weren't allowed to eat or drink before surgery and you are allowed minimal food and fluids after surgery.  Drinking fluids will fix this problem. 

Second, during general anesthesia, an endotracheal tube is put into your mouth and down your throat, a process called intubation. This tube is then attached to the ventilator to provide oxygen and breaths during surgery and potentially during the early stages of recovery.

The endotracheal tube insertion can be irritating to the throat, tongue, and vocal cords. The process of having the breathing tube inserted can be irritating to the throat, and having the tube remain in place can cause further irritation in the mouth and throat. After the tube is removed, patients often find that their mouth, throat and airway are irritated and may experience burning and other symptoms.

If the patient's condition requires a prolonged stay on the ventilator, the resulting sore throat may be more significant.  In fact, most facilities will encourage that a patient have a tracheostomy if the breathing tube and ventilator will be necessary for more than 10-14 days, as leaving the tube in place for too long can cause permanent damage to the vocal cords.


What to Do About It

Normal sore throat care including minimal speaking, drinking lots of fluids and over-the-counter remedies should do the trick within a few days. Numbing lozenges with benzocaine are particularly effective for this type of irritation, as the medication coats and protects the throat while numbing the area. Sucking on candy, particularly citrus flavors like lemon, can help keep the area more lubricated to decrease pain.

Drinking more fluids can be helpful in keeping the throat wet 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 others cold/icy treats, but avoid citrus such as orange or lemon as they can be irritating to already tender tissues. 

When a Sore Throat After Surgery Is Serious

If your sore throat persists more than a week, consider consulting your surgeon or another doctor.  If you feel that your voice has been affected, contact your surgeon. Permanent throat or vocal cord injury is rare, but it is one of the risks of anesthesia and early intervention and treatment can make a dramatic difference in the final outcome.  

Don't ignore a throat problem that isn't improving notably in the days following surgery.

 Most people report that their sore throat is no longer an issue within three to four days after surgery and they are back to eating and drinking without difficulty.

Keep in mind that it is absolutely possible that the sore throat is unrelated to the surgery. For example, a person might have surgery that caused a mild sore throat, but could potentially have strep throat in the days that follow that cause increasing discomfort and will require antibiotic treatment.


Patient Education FAQ, American Society of Anesthesiologists. http://www.asahq.org/patientEducation.htm