Abstract
BackgroundThe increase in endotracheal tube cuff pressure due to nitrous oxide diffusion is a well-known risk during general anesthesia using nitrous oxide. We hypothesized that lubricating endotracheal tube cuffs with K-Y™ Jelly might inhibit the increase in cuff pressure that occurs during exposure to nitrous oxide.MethodsWe used two types of endotracheal tube cuffs: one made from ultrathin polyurethane (PU) and another made from conventional polyvinyl chloride (PVC). Using a pediatric trachea model, which consisted of an acrylic cylinder with an internal diameter of 12 mm, we measured changes in the cuff pressure during nitrous oxide exposure in size 5.0-mm internal diameter endotracheal tubes with each type of cuff, with and without lubrication with K-Y™ Jelly.ResultsDuring nitrous oxide exposure, the increase in cuff pressure was significantly lower in the lubricated cuffs than in the non-lubricated cuffs in both types of cuffs (PVC, P < 0.0001; PU, P < 0.0001). However, the cuff compliance in the trachea model was unaffected by lubrication in both types of cuffs.ConclusionsLubrication of endotracheal tube cuffs with K-Y™ Jelly may effectively delay the increase in cuff pressure that occurs during general anesthesia using nitrous oxide.
Highlights
The increase in endotracheal tube cuff pressure due to nitrous oxide diffusion is a well-known risk during general anesthesia using nitrous oxide
In stationary conditions, cuff pressure increased with time in both the polyvinyl chloride (PVC) (P < 0.0001; F = 49.1) and PU cuffs (P < 0.0001; F = 34.8), and this increase was higher without lubrication in both the PVC (P < 0.0001; F = 246.3) and PU cuffs (P < 0.0001; F = 208.1)
Lubrication with K-YTM Jelly strongly inhibited the increase in cuff pressure in PVC cuffs and totally abolished the cuff pressure increase in PU cuffs
Summary
The increase in endotracheal tube cuff pressure due to nitrous oxide diffusion is a well-known risk during general anesthesia using nitrous oxide. The increase in endotracheal tube (ETT) cuff pressure due to nitrous oxide (N2O) diffusion is a well-known risk during general anesthesia using N2O [1,2,3]. Ischemic tracheal mucosal damage followed by edema after extubation is especially problematic in pediatric patients due to the smaller internal diameter (ID) of the trachea and the presumed lower perfusion pressure of. It has been well documented in laboratory and clinical studies that lubrication of ETT cuffs reduces liquid and air leakage around the cuffs [6,7,8,9]. In the Koyama et al BMC Anesthesiology (2018) 18:99 present study, we tested this hypothesis using a rigid pediatric trachea model and the two types of ETT cuffs with or without lubrication with K-YTM Jelly
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