Evaluation of Endotracheal Tube Cuff Pressure in Laparoscopic Cholecystectomy and Postoperative Sore Throat

Lakhe, Gajal; Sharma, Surendra Mohan

doi:10.3126/jnhrc.v15i3.18856

Cited by 13 publications

(10 citation statements)

References 5 publications

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“…It is mainly related to injury of tracheal mucosa, mucosal inflammation and ischemia caused by endotracheal intubation [4]. Besides, intubation without the neuromuscular block agent, intubation with double-lumen endotracheal tube, or excessive pressure of the cuff may also increase the risk of POST [11]. Some POST patients may recover by themselves, but some patients could be affected by POST for a long time, which seriously decreases the satisfaction of patients with anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

He²,

Wang³

et al. 2020

PLoS ONE

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Introduction Ultrasound-guided internal branch of the upper laryngeal nerve block (USG-guided iSLN block) have been used to decrease the perioperative stress response of intubation. It is more likely to be successful than blindly administered superior laryngeal nerve blocks with fewer complications. Here, we evaluated the efficacy of USG-guided iSLN block to treat postoperative sore throat (postoperative sore throat, POST) after extubation. Methods 100 patients, aged from 18 to 60 years old, ASA I~II who underwent general anesthesia and suffered from the moderate to severe postoperative sore throat after extubation were randomized into two groups(50 cases per group). Patients in group S received USG-guided iSLN block bilaterally (60mg of 2% lidocaine, 1.5ml each side), whereas those in group I received inhalation with 100 mg of 2% lidocaine and 1mg of budesonide suspension diluted with normal saline (oxygen flow 8 L /min, inhalation for 15 minutes). The primary outcome were VAS scores in both groups before treatment (T0), 10 min (T1), 30 min(T2), 1h(T3), 2 h(T4), 4h(T5), 8h(T6), 24h(T7), and 48h(T8) after treatment. The secondary outcome were satisfaction scores after treatment, MAP, HR, and SPO2 fromT0 to T8. The adverse reactions such as postoperative chocking or aspiration, cough, hoarseness, dyspnea were also observed in both groups. Results Patients in group S had significantly lower VAS score than that in group I at points of T1 ~ T6 (P < 0.01). HR of group S was lower than that of group I at points of T1 ~ T2and T4 (P < 0.05), and MAP was lower than that of group I at points of T1 ~ T3 (P < 0.05). Satisfaction scores of group S were higher than that of group I (P <0.05), In group S, 2 case (4%) needed to intravenous Flurbiprofen Injection 50 mg to relieve pain; in group I, 13 cases (26%) received Flurbiprofen Injection. 2 case of group S appeared throat numbness after treatment for 3 hours; 2 patients have difficult in expectoration after treatment recovered after 3hour. No serious adverse events were observed in both groups. Conclusion Compared with inhalation, USG-guided iSLN block may effectively relieve the postoperative sore throat after extubation under general anesthesia and provided an ideal treatment for POST in clinical work.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

He²,

Wang³

et al. 2020

PLoS ONE

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“…There was an increased incidence of sore throat among the group using nitrous oxide than in the group using air, which was statistically significant at 2 hours and 4 hours postoperatively. Lakhe et al 23 conducted a study to evaluate cuff pressure and the incidence of postoperative sore throat. They observed an increase in cuff pressure and postoperative sore throat by using nitrous oxide in laparoscopic surgeries which is similar to our study results.…”

Section: Discussionmentioning

confidence: 99%

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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“…Though, previous studies assumed that patients inter individual variability such as the anatomy of trachea, cuff positioning over trachea and cuff physical characteristics such as material, diameter, thickness, measured during the period an endotracheal tube is in situ, nor is repeated cuff pressure monitoring performed on fixed moments. In the meanwhile, monitoring of the cuff pressure is a simple, noninvasive and efficient way to achieve therapeutic cuff pressures in the range of 20 to 30 cm H 2 O (5,19). This range is said to be adequate and safe (20).…”

Section: Cuff Pressure (Cmh2o) Is Represented On the X-axis Peak Pres...mentioning

confidence: 99%

Establishing changes in endotracheal cuff pressure with continuous monitoring in patients undergoing laparoscopic surgery in Trende- lenburg position

Renders¹,

Gijsbrechts²,

Bijleveld³

et al. 2021

Acta Anaest Belg

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Background : After endotracheal intubation, the endotracheal cuff gets inflated to a sufficiently high pressure to prevent air leaking. Placing a patient in Trendelenburg position and establishing a pneumoperitoneum affects the endotracheal cuff pressure. Objectives : Determine the impact of these factors on the endotracheal cuff pressure. Design and setting : This prospective, observational study was conducted in the Catharina Hospital (Eindhoven, the Netherlands). Methods : This study included adult patients undergoing laparoscopic surgery. A routine endotracheal tube was inserted, in which the cuff pressure was continuously monitored. Main outcome measures : The outcome of interest was a change in endotracheal cuff pressure after establishment of a pneumoperitoneum and/ or placing a patient in a Trendelenburg position. Results : 39 patients were included. Cuff pressures in- creased significantly from the moment of pneumo-peritoneum, placing a patient into a Trendelenburg position increased endotracheal cuff pressure and peak pressures even more. The highest endotracheal cuff pressure was 67 cm H2O, the highest registered peak pressure was 35 cm H2O. Conclusion : Both endotracheal cuff pressure and peak pressure increased during laparoscopic surgical procedures with a pneumoperitoneum and the patient placed in Trendelenburg position. Measuring the endo-tracheal cuff pressure only after endotracheal intubation is insufficient and should be repeated during surgery on fixed moments.

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Evaluation of Endotracheal Tube Cuff Pressure in Laparoscopic Cholecystectomy and Postoperative Sore Throat

Cited by 13 publications

References 5 publications

Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

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

Establishing changes in endotracheal cuff pressure with continuous monitoring in patients undergoing laparoscopic surgery in Trende- lenburg position

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