Comparison of endotracheal tube cuff pressure changes using air versus nitrous oxide in anesthetic gases during laparoscopic abdominal surgeries

Mogal, Shweta Sarjerao; Baliarsing, Lipika; Dias, Raylene; Gujjar, Pinakin

doi:10.1016/j.bjane.2018.01.015

Cited by 8 publications

(5 citation statements)

References 20 publications

(26 reference statements)

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“…In this study, the cuff pressure started to increase in both the groups after 30 minutes, which can be explained by the pneumoperitoneum, the increase in cuff pressure in the nitrous oxide group was higher when compared to the air group at various time intervals and it was statistically significant at 60 minutes which may be due to diffusion of nitrous oxide into the cuff. This is similar to the study by Mogal et al 21 where they compared the endotracheal cuff pressure changes during laparoscopic surgeries using air versus nitrous oxide in the anaesthetic mixture. They observed that cuff pressure in the group using nitrous oxide was higher when compared to the group using air.…”

Section: Discussionsupporting

confidence: 86%

A Comparative Study of Cuff Pressure Changes of Endotracheal Tube with the Use of Air Versus Nitrous Oxide in the Anaesthetic Gas Mixture During Laparoscopic Surgery

Johny¹,

Sivalingam²,

Vidya³

et al. 2022

Turk J Anaesthesiol Reanim

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Objective: Cuffed endotracheal tube remains the standard of care during laparoscopic surgeries. Nitrous oxide is widely used as a carrier gas in anaesthesia practice. Cuff pressure greater than 30 cm H 2 O impairs tracheal mucosal perfusion leading to necrosis. This study aimed to compare the endotracheal tube cuff pressure while using air versus nitrous oxide in the anaesthetic gas mixture during laparoscopic surgeries. Methods: Sixty patients aged 18-70 years undergoing laparoscopic surgery were randomized into 2 groups of 30 each. Group 1 patients received air and oxygen in the anaesthetic gas mixture and group 2 patients received nitrous oxide and oxygen. Cuff pressure changes were measured throughout the surgery and perioperative hemodynamic parameters were recorded. The incidence and severity of postoperative sore throat were also evaluated postoperatively for 24 hours. Results: The increase in cuff pressure was more in the group using nitrous oxide (40.80 ± 8.78 cm H 2 O) when compared to the group using air (26.93 ± 2.69 cm H 2 O) ( P < .001). Trendelenburg position was associated with a significant increase in cuff pressure when compared to other positions. The incidence and severity of postoperative sore throat were more at 2 hours ( P = .0099) and 4 hours ( P = .0105) postoperatively in the group using nitrous oxide. The hemodynamic parameters were comparable between the 2 groups. Conclusion: The use of nitrous oxide in the anaesthetic gas mixture causes an increase in endotracheal tube cuff pressure and increased severity of postoperative sore throat during laparoscopic surgeries.

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Section: Discussionsupporting

confidence: 86%

A Comparative Study of Cuff Pressure Changes of Endotracheal Tube with the Use of Air Versus Nitrous Oxide in the Anaesthetic Gas Mixture During Laparoscopic Surgery

Johny¹,

Sivalingam²,

Vidya³

et al. 2022

Turk J Anaesthesiol Reanim

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“…The method results in hyperinflation explained by the great variability in the air volume required to achieve adequate cuff pressure due to variations in patient profiles, tube diameters, gases used during mechanical ventilation, and by the health professional’s goal to minimize risks of pulmonary aspiration of the gastric content. 3 , 11 , 14 , 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

“…Distinct strategies, using subjective and objective methods, have been proposed to attain adequate control of the cuff pressure and reduce the risks of complications. 11 , 12 , 13 , 14 , 15 , 16 , 17 However, evidence adds up against using subjective methods, and also signals toward a non-correlation between measured cuff pressure and age, sex, height and weight of patients. Additionally, pressures measured do not differ as a function of tracheal tube size or of the expertise of the professional executing the procedure.…”

Section: Introductionmentioning

confidence: 99%

Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study

Duarte

Caetano

Arouca

et al. 2020

Brazilian Journal of Anesthesiology (English Edition)

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“…Various other factors have also been studied such as, correlation to body mass index (BMI), patient position, duration of pneumo-peritoneum and use of nitrous oxide. [ 8 9 10 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

A prospective observational study on changes in endo-tracheal tube cuff pressure and its correlation with airway pressures during various stages of robotic pelvic surgeries

Dhar¹,

Gupta²,

Tandon³

et al. 2022

J Anaesthesiol Clin Pharmacol

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Background and Aims: Robotic surgeries often require a relatively long duration of pneumo-peritoneum and trendelenburg position which may accentuate changes in endo-tracheal tube (ETT) cuff pressure leading to pressure related complications. The aim of this study was to analyze changes in ETT cuff pressures during various stages of pneumo-peritoneum and surgical positioning and its correlation with airway pressure changes. Material and Methods: A prospective observational study was planned after approval of institutional review board on 60 patients undergoing elective robotic pelvic surgery requiring head down position. Baseline cuff pressure was adjusted to 25 cm H 2 O. ETT cuff pressure, peak airway pressure and end tidal CO 2 (ETCO 2 ) was measured at various time intervals before and after pneumo-peritoneum and head down. Ventilatory parameters were kept fixed after baseline setting. Those requiring any change were excluded. Pearson’s coefficient was used for correlation and ANOVA for trend of parameters at different time intervals (P value <0.05 was considered significant). Results: Baseline cuff pressure after manual inflation was 46.2 ± 17.4 cm H 2 O. Significant correlation was observed between change in cuff pressure and increase in peak airway pressure at the end of the surgery (r = 0.4, P < 0.05). Serial measurements of ETT cuff pressure, peak airway pressure and ETCO 2 were significantly increased compared to baseline (P < 0.05). Conclusion: Significant increases in ETT cuff pressure may be seen in robotic surgeries, with a positive correlation between change in cuff pressure and increase in airway pressures. Objective adjusted measurement of cuff pressure and airway pressures is recommended for such surgeries.

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Comparison of endotracheal tube cuff pressure changes using air versus nitrous oxide in anesthetic gases during laparoscopic abdominal surgeries

Cited by 8 publications

References 20 publications

A Comparative Study of Cuff Pressure Changes of Endotracheal Tube with the Use of Air Versus Nitrous Oxide in the Anaesthetic Gas Mixture During Laparoscopic Surgery

A Comparative Study of Cuff Pressure Changes of Endotracheal Tube with the Use of Air Versus Nitrous Oxide in the Anaesthetic Gas Mixture During Laparoscopic Surgery

Subjective method for tracheal tube cuff inflation: performance of anesthesiology residents and staff anesthesiologists. Prospective observational study

A prospective observational study on changes in endo-tracheal tube cuff pressure and its correlation with airway pressures during various stages of robotic pelvic surgeries

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