Bougie Effects on Endotracheal Cuff Pressure and Sore Throat in Bariatric Surgery

Abstract

Purpose: The purpose of this study was to evaluate the effects of a bougie insertion on the endotracheal cuff pressure and incidence of sore throat in sleeve gastrectomies. Materials and Methods: In this study, 40 patients scheduled for sleeve gastrectomies were enrolled and randomly allocated into two groups. The endotracheal tube (ETT) cuff pressures were set to 25 mmHg after intubation and the pressures were continuously monitored. In Group 1, the ETT cuff pressure was adjusted to 25 mmHg after the insertion of the bougie device, whereas in Group 2, the cuff pressure was not manipulated after the insertion of the bougie. The peak airway pressures and cuff pressures were recorded every 5 min in both groups, and the bougie insertion time, bougie duration, laryngoscopic and bougie complications, and surgery durations were noted. The incidence of postoperative sore throat was assessed and classified as none, mild, moderate, and severe. Results: There were no differences between the groups in the demographic variables, duration of surgery, peak airway pressure, or duration of bougie use. The bougie insertion time was at 28 ± 9 and 30 ± 10 min into the surgery in Groups 1 and 2, respectively. The cuff pressures were significantly higher in Group 2 at 20, 25, 30, and 35 min (p < 0.05), and the endotracheal cuff pressures exceeded 30 mmH2O in nine patients in Group 2. The postoperative sore throat scores were significantly higher in Group 2 at the 30th minute and at the 2nd and 24th hours. Conclusion: The insertion of a bougie may increase the cuff pressure and exacerbate a postoperative sore throat. Continuous cuff pressure monitoring and readjusting the cuff pressure after the bougie insertion procedure may alleviate a postoperative sore throat in bariatric surgery.