Tracheal or nasal intubation for general anesthesia causes airway mucosa trauma resulting in postoperative sore throat (POST), hoarseness, and cough . POST is a minor and common problem in patients undergoing endotracheal intubation , which commonly occurs 12 to 24 hours after the operation. Despite the mildness of symptoms, POST is one of the major cause of post operative dissatisfaction after surgery . In most cases, POST heals after surgery without specific treatment. Moderate to severe POSTS with dysphagia and pain can be treated with pharmacological agents.

Ketamine, a dissociative anesthetic agent, is the most potent of NMDA antagonists. Ketamine interacts noncompetitively with the NMDA receptors, suppresses the NMDA receptor mediated central sensitization, and potentially decreases postoperative pain

Dexmedetomidine is an alpha2 adrenergic agonists which have sedative, hypnotic  ,anxiolytic, analgesic, and sympatholytic effects. The analgesic effect of dexmedetomidine is mediated through stimulation of alpha 2c and alpha 2a receptors in the dorsal horn directly suppressing pain transmission by reducing the release of pronociceptive transmitters, substance P and glutamate and hyperpolarization of interneurons.

Therefore, this study attempted primarily to shed light upon the efficacy of dexmedetomidine intraoral spray versus ketamine intraoral spray on reducing postoperative sore throat  after tonsillectomy.