Abstract
Background: Endotracheal intubation is a common procedure in routine anaesthesisa practice. Inadvertently high cuff pressure of endotracheal tube may result in several complications. Method of cuff inflation is directly related to complications encountered. Two most common methods of cuff inflation is digital palpation method or by using pressure guage. Use of pressure guage for cuff inflation has been proved as better method in earlier studies.
Method: After approval from ethical committee at RIMS, Ranchi 60 patients were included in this randomized controlled observational study who were planned for general anaesthesia with endotracheal intubation. Patients were equally distributed in two groups. In one group cuff was inflated by digital palpation method and in another group cuff was inflated to 25cm H2O by using pressure guage. Both groups were compared with regard to occurrence of sore throat and hoarseness of voice just after extubation and after 24 hours.
Result: Occurrence of sore throat and hoarseness of voice was significantly low in pressure gauge group.
Keywords: Endotracheal intubation, cuff pressure, pressure guage, sore throat, hoarseness of voice.
References
- Lomholt N. A device for measuring the lateral wall cuff pressure of endotracheal tubes. Acta anaesthesiolscand. 1992; 36: 775-778.
- Bernhard WN, Yost L, Joynes D, Cothalis S, Turndurf H. Intracuff pressures in endotracheal and tracheostomy tubes. Related cuff physical characteristics. Chest. 1985; 87:720-725.
- Agarwal A, Nath SS, Goswami D, Gupta D, Dhiraaj S, Singh PK. An evaluation of the efficacy of aspirin and benzydamine hydrochloride gargle for attenuating postoperative sore throat: A prospective, randomized, single-blind study. Anesth Analg. 2006;103:1001–3.
- Seegobin R D, Hasselt G L. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. British Medical Journal.1984; 288:965-968.
- Gemechu BM, Gebremedhn EG, Melkie TB. Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014. Pan Afr Med J. 2017;27:127. Published 2017 Jun 16. doi:10.11604/pamj.2017.27.127.10566.
- Stevanovic A, Rossaint R, Fritz HG, etal.Airway reactions and emergence times in general laryngeal mask airway anaesthesia: a meta-analysis. Eur J Anaesthesiol 2015; 32:106–116.
- Kim D, Jeon B, Son JS, et al.The changes of endotracheal tube cuff pressure by the position changes from supine to prone and the flexion and extension of head. Korean J Anesthesiol 2015; 68: 27–31.
- Terashima H, Sakurai T, Takahashi S, Saitoh M, Hirayama K. Postintubation tracheal stenosis: Problems associated with choice of management. KyobuGeka .2002; 55:837-42.
- Trivedi L, Jha P, Bajiya NR, Tripathi D. We should care more about intracuff pressure: The actual situation in government sector teaching hospital. Indian J Anaesth. 2010;54(4):314–317. doi:10.4103/0019-5049.68374.
- Hu B, Bao R, Wang X, Liu S, Tao T, et al. (2013) The Size of Endotracheal Tube and Sore Throat after Surgery: A Systematic Review and Meta-Analysis. PLoS ONE 8(10):e74467.doi:10.1371/journal.pone.0074467.
Corresponding Author
Dr Ekramul Haque
Associate Professor, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi