A study to understand the current practices regarding the use of cuffed endotracheal tubes in pediatric anaesthesia amongst Indian anaesthesiologists

Abstract

Purpose: To understand the current practices regarding the use of cuffed endotracheal tubes in paediatric anaesthesia amongst Indian anaesthesiologists.Methods: We formulated a questionnaire intended to assess the use of cuffed endotracheal tubes in pediatric age-group by pediatric and general anaesthetics in India. The questionnaire was also designed to evaluate practices related to the use of cuffed endotracheal tube in pediatric age group, such as the medium used for inflation of the cuff and whether or not cuff pressure monitoring was done during surgery. The self-structured questionnaire had 23 questions, and they were widely shared amongst anaesthetists practicing in India through social media, such as Facebook groups, WhatsApp groups and direct messages, over a period of three months from November 2021 to January 2022. Results and conclusion: We found that more number of cuffed ETT has been seen to be used by the practitioners who are in the age group of 25 to 40 years. More number of cuffed ETT has been used by female practitioners for paediatric anaesthesia. Strong association has been observed between years of practice of preference of practitioners for the type of ETT, with practitioners with less than 10 years post PG experience preferring cuffed ETT while those with post PG experience of > 20 years preferring uncuffed ETT. We also concluded that majority practitioners prefer uncuffed ETT in neonates and in children between 1 month to 2 years of age, while most of them prefer cuffed ETT in children above 2 years of age. We also concluded that even though use of cuffed endotracheal tubes in pediatric patients is on a rise, the percentage of anaesthesiologists who monitor intraoperative cuff pressure is very low, thus compromising the safety.