Correlation of Endotracheal Tube Size with Sore Throat and Hoarseness Following General Anesthesia

Stout, David M; Bishop, Michael J.; Dwersteg, Jochen F.; Cullen, Bruce F.

doi:10.1097/00000542-198709000-00025

Cited by 237 publications

(170 citation statements)

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“…In our study, the incidence of sore throat of 16% in the tracheal tube group is lower than those reported in previous studies of 22-48% depending on the size of tracheal tube used [8,9]. The incidence of sore throat in the LMA group (12%) is similar to that reported by Brodrick [10] and slightly higher than the 6-8% reported by others [11,12].…”

Section: Discussionsupporting

confidence: 70%

“…The incidence of sore throat does appear to decrease with increased clinical experience in using the LMA [7]. Hoarseness occurred in 44% in the tracheal tube group, a slightly higher incidence than those reported in previous studies: 18-42% depending on the size of tracheal tube used [9,14]. The low incidence of hoarseness (12%) in the Combitube and LMA groups might be related to the lack of contact made by both of these airway devices with the vocal cords.…”

Section: Discussionmentioning

confidence: 99%

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Complications following the use of the Combitube, tracheal tube and laryngeal mask airway

Oczenski¹,

Krenn²,

Dahaba³

et al. 1999

Anaesthesia

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SummaryIn a prospective, randomised trial, 75 patients scheduled for routine surgery were randomly allocated to one of three groups to evaluate trauma and postoperative complications after insertion of the Combitube, tracheal tube or laryngeal mask airway. Insertion of the Combitube was associated with a higher incidence of sore throat (48% vs. 16% vs. 12% [p < 0.01]) and dysphagia (68% vs. 12% vs. 8% [p < 0.01]) compared with tracheal intubation or insertion of the laryngeal mask airway, respectively. Hoarseness was significantly less common in both the Combitube and the laryngeal mask groups (both 12%) than in the tracheal tube group (44%; p < 0.01). Haematoma occurred in 36% of the Combitube group compared with 4% in both the laryngeal mask and the tracheal tube groups (p < 0.01). The higher incidence of complications should be considered when using the Combitube.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Complications following the use of the Combitube, tracheal tube and laryngeal mask airway

Oczenski¹,

Krenn²,

Dahaba³

et al. 1999

Anaesthesia

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“…The size of endotracheal tube contributes significantly to the occurrence of laryngeal morbidity. 22 This factor may also explain our somewhat lower incidence of postoperative laryngeal symptoms, recorded 24 hr after anesthesia, than reported by Combes et al, 6 although female gender, gynecological surgery, and duration of intubation are well known risk factors for complaints of laryngeal symptoms after anesthesia. 2,3 Finally, the selected doses of remifentanil and propofol ensured acceptable intubating conditions in more than 95% of patients.…”

Section: Discussionmentioning

confidence: 61%

Laryngeal injuries and intubating conditions with or without muscular relaxation: an equivalence study

Bouvet

Stoian

Jacquot-Laperrière

et al. 2008

Can J Anesth/J Can Anesth

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Purpose:The need for muscular relaxation to improve intubating conditions and to reduce the incidence of laryngeal morbidity is still controversial. The aim of this study was to determine the incidence of symptomatic laryngeal injuries (SLI) and of acceptable intubating conditions (including both good and excellent conditions), both with and without cisatracurium during induction of anesthesia, along with moderate doses of remifentanil and propofol. Methods:In this prospective, randomized double-blind equivalence trial, the intubating conditions were compared in 130 ASA I or II female patients. All subjects received remifentanil 2 µg·kg -1 iv and propofol 2.5 mg·kg -1 iv, with either cisatracurium 0.15 mg·kg -1 iv (group Cisatracturium), or saline (group Placebo). Tracheal intubating conditions were assessed with the Copenhagen Score. A systematic screening for postoperative hoarseness and sore throat was performed 24 and 48 hr after anesthesia, followed by a nasofibroscopic examination when laryngeal symptoms persisted at 48 hr.Results: Twenty-four hr after anesthesia, the incidence of postoperative hoarseness and sore throat in the Cisatracurium and Placebo groups was 26.5% and 21.5%, respectively, and 48 hr after anesthesia, the incidence was 7.8% and 6.1%, respectively (P = 0.32 and P = 0.50 between groups, respectively). In the clinically evaluable population, the incidence of SLI, assessed at 48 hr by nasofibroscopy, was equivalent in both groups, 1.6% vs 1.5% in group Placebo and group Cisatracurium, respectively (P < 0.001 for equivalence test), as was the occurrence of acceptable intubating conditions (95.4% vs 100%, P < 0.05 for equivalence test). However, the occurrence of excellent intubating conditions was more frequent in group Cisatracurium than in group Placebo (P = 0.0003). Conclusion:Following induction of anesthesia with propofol and moderate-dose remifentanil, cisatracurium did not confer a higher rate of good-to-excellent conditions for tracheal intubation, nor did muscle relaxation with cisatracurium decrease the rate of SLI after tracheal intubation.

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“…This conformational force would be lower for smaller or softer tubes. Whilst the incidence of sore throats has been shown to be lower for smaller tubes [14], little attention has been paid to the material from which the tube is made. Thus a comparison of plastic tubes and red rubber tubes [5] describes the different cuff types but does not comment on the very different characteristics of the tubes.…”

Section: Discussionmentioning

confidence: 99%

Tracheal intubation and sore throat: a mechanical explanation

Chandler¹

2002

Anaesthesia

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SummaryAlthough tracheal intubation remains a valuable tool, it may result in pressure trauma and sore throat. The evidence for an association between these sequelae is not conclusive and sore throat may be caused at the time of intubation. This hypothesis was tested in a mechanical model and the results from tracheal intubation compared with those from insertion of a laryngeal mask airway, which is associated with a lower incidence of sore throat. Use of the model suggests that the tracheal tube and laryngeal mask airway impinge on the pharyngeal wall in different manners and involve different mechanisms for their conformation to the upper airway, but that in a static situation, the forces exerted on the pharyngeal wall are low with both devices. It also suggests that the incidence of sore throat should be lower for softer and smaller tracheal tubes and that the standard`Magill' curve (radius of curvature 140^20 mm) is about optimum for the average airway.

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Correlation of Endotracheal Tube Size with Sore Throat and Hoarseness Following General Anesthesia

Cited by 237 publications

References 0 publications

Complications following the use of the Combitube, tracheal tube and laryngeal mask airway

Complications following the use of the Combitube, tracheal tube and laryngeal mask airway

Laryngeal injuries and intubating conditions with or without muscular relaxation: an equivalence study

Tracheal intubation and sore throat: a mechanical explanation

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