Abstract
BackgroundEndotracheal tube cuff (ETTc) inflation pressure is usually not regarded as an important aspect during intubation. In this study, we compared measuring ETTc pressure and pilot balloon palpation method in causing post-operative airway complications.MethodsTwo hundred and ninety-two surgical patients requiring intubation were recruited into this prospective, double-blind, randomised controlled study. Group A patients had their ETTc initially inflated, checked by a cuff pressure gauge, recorded and then set to 25 cmH2O. Group B patients had their ETTc inflated using the pilot balloon palpation method. Patients were then followed up for post-operative sore throat, hoarseness and cough.ResultsThe overall incidence of post-operative sore throat was 39.0% versus 75.3% (P < 0.001), hoarseness 6.2% versus 15.1% (P < 0.05) and cough 7.5% versus 21.9% (P < 0.05) in Group A and B, respectively. Group A patients experienced a significant reduction in the incidence and severity of sore throat up to 24 h post-operatively (P < 0.001), hoarseness at the first hour (P = 0.004) and cough at first and 12 h post-operatively (P = 0.002).ConclusionAdjusting the ETTc pressure to 25 cmH2O reduces post-operative sore throat, hoarseness and cough compared to pilot balloon palpation method.
Highlights
Post-operative sore throat (POST) and hoarseness of voice are complications of general anaesthesia requiring tracheal intubation, with reported incidences of sore throat varying from 11% to 48% and hoarseness from 18% to 53% [1]
Two hundred and ninety-two patients aged 18 years and above with American Society of Anesthesiologists (ASA) physical status I, II or III who were scheduled for elective surgery in the supine position under general anaesthesia requiring oral endotracheal intubation were included in the study
This study showed that the overall incidence of POST was 39.0% versus 75.3% (P = 0.000), hoarseness 6.2% versus 15.1% (P = 0.014) and cough 7.5% versus 21.9% (P = 0.001) in Groups A and B, respectively
Summary
Post-operative sore throat (POST) and hoarseness of voice are complications of general anaesthesia requiring tracheal intubation, with reported incidences of sore throat varying from 11% to 48% and hoarseness from 18% to 53% [1]. POST may be considered a minor problem that resolves spontaneously after a few days, but it can cause distress and decrease the quality of recovery and patient satisfaction [2]. The mechanism is believed to involve erosion of the tracheal mucosa caused by the cuff of a tracheal tube, trauma from tracheal intubation and mucosal dehydration [3]. Over-inflation of the endotracheal tube cuff (ETTc) affects blood supply to the tracheal mucosa, which may result in tracheal mucosal ischemia, ulceration, necrosis or tracheoesophageal fistula [4]. An endoscopic study on mucosal blood flow by. Endotracheal tube cuff (ETTc) inflation pressure is usually not regarded as an important aspect during intubation. We compared measuring ETTc pressure and pilot balloon palpation method in causing post-operative airway complications
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