Increases in Cuff Volume and Pressure in Red Rubber Endotracheal Tubes during Anaesthesia

Wr, Thompson; Te, Oh

doi:10.1177/0310057x7900700207

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…Seegobin and Van Hasselt l 5 have stressed that when such a tube is employed the cuff pressure must be kept as low as is compatible with effective sealing. and must not exceed capillary perfusion pressure (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). This can be done by connecting the cuff line to a pressure gauge.…”

Section: Discussionmentioning

confidence: 99%

Concurrent drug therapy in patients undergoing surgery

et al. 1987

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SummaryIn a retrosperiive study of 57 176 patients and a prospective study of 216 patients undergoing surgery, 24-32% of paiienis were receiving some concurrent medication. Between I0 and 16?h were taking drugs for cardiovascular disease. Of these, only 71% had iheir normal medication prescribed before surgery und only 41% received their drugs on the day of surgery. Key wordsDrugs; pre-operative treatment Concurrent drug therapy is important in patients undergoing surgery because of possible interactions with anacsthetic drugs and because of the difficulty in maintaining normal drug therapy in the peri-operative period when patients may fast for long periods of time. We report a survey of patient compliance at this time. Puiienrs and methodsThe anaesthetic records of 57 176 patients undergoing surgery in the Western Infirmary, Glasgow between April 1980 and November 1983 were reviewed previously.' On each form, the anaesthetist had recorded the presence and nature of any concurrent disease. In addition, coexistent drug therapy was notcd. These data were filed on computer and retrieved subsequently.In a prospective study of 216 consecutive patients undergoing general or orthopacdic surgery in two surgical units of the same hospital during April and May 1984, each patient was interviewed before and after surgery. Any concurrent disease and drug therapy were recorded. Regular medication was defined as more than 2 weeks' duration. Patient compliance with the regular medication on the day of surgery was determined from the nursing records. This was done without explaining the reasons to the nurses. in an attempt to avoid changing their normal practice. ResultsOf the 57 176 patients studied retrospectively, 13 703 (24%) were taking some medication regularly (Table I). Just under half of these latter patients (5 999; 10% of the total) were taking drugs for some disease of the cardiovascular system. This group represents some two-thirds of the 8 618 patients undergoing surgery who had cardiovascular disease. In the prospective study, 32% or the patients were taking regular medication and half of these (16%) were taking drugs for disease of the cardiovascular system ( DiscussionConcurrent drug therapy is common in patients undergoing surgery. Some one in four patients might be expected to be taking some medication at the time of their operation. It is likely that drugs prescribed for cardiovascular disease are most relevant with respect to drug interactions with anaesthetic agents and our data suggest that one in ten patients are taking these drugs. An unexpected but important result of our study is the frequency of acute withdrawal of concurrent medication before surgery. Both studies included patients undergoing elective and emergency surgery. The pattern of drug use was the same in both groups while the frequency of acute withdrawal of drugs was higher in the emergency patients (74 and 44% for emergency and elective patients, respectively). This may be hazardous for some drugsT2 in particular / J ' -adrenoreceptor a...

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Section: Discussionmentioning

confidence: 99%

Concurrent drug therapy in patients undergoing surgery

et al. 1987

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“…The third method is the use of something other than air to inflate the cuff, e.g. saline or nitrous oxide [6, 7, 19]. Although each of these methods is effective in its own way, few seem to be routinely used in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

A simple method to control tracheal cuff pressure in anaesthesia and in air evacuation

et al. 1999

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SummaryThe pressure within latex balloons remains constant despite the balloons being in¯ated to more than 40 times their initial volume. We used this property to enable improved tracheal cuff pressure control. A latex balloon with an initial volume of 5 ml was connected via a vinyl duct attached with a roller clamp and three-way stopcock to a standard tracheal tube cuff. The 5 ml latex balloon was then in¯ated with 250 ml of air. The pressure within the tracheal tube cuff was monitored throughout anaesthesia with the in¯ated latex balloon acting as a pressure controller. Throat symptoms were recorded on the ®rst four postoperative days. The controller kept the tracheal tube cuff pressures constant, and reduced the incidence of postoperative throat symptoms. Variations in cuff pressures with and without the controller were investigated in an altitude chamber to simulatē ight. In the altitude chamber, cuff pressure reached over 200 cmH 2 O at 10 000 feet without the controller, whereas such variations were practically eliminated when the controller was used.

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“…However, there was no statistical difference between the cuff pressures in our study. The pressures inside all the cuffs increased during the period of anaesthesia, due to nitrous oxide diffusing into the cuff [18]. Positive pressure ventilation through a small tube will usually need to be converted to spontaneous ventilation before extubation.…”

mentioning

confidence: 99%

Small tubes revisited

Koh¹,

Hare²,

Calder³

1998

Anaesthesia

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SummaryWe measured the peak inflation and end expiratory pressure at the proximal and distal ends of two sizes of tracheal tube in men and women receiving positive pressure ventilation. There was a statistically significant increase in proximal inflation pressure when the smaller size of tube (6.5 mm for men, 6.0 mm for women) was used. There was no increase in distal inflation or end expiratory pressures. Clinically satisfactory positive pressure ventilation was obtained when 6.0 and 6.5 mm tracheal tubes were used. The advantages and disadvantages of using small sizes of tracheal tube are discussed.

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Increases in Cuff Volume and Pressure in Red Rubber Endotracheal Tubes during Anaesthesia

Cited by 10 publications

References 15 publications

Concurrent drug therapy in patients undergoing surgery

Concurrent drug therapy in patients undergoing surgery

A simple method to control tracheal cuff pressure in anaesthesia and in air evacuation

Small tubes revisited

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