Laryngotracheal Complications of Endotracheal Intubation

Suzuki, Takahiro; Shirota, Masamichi; Takemoto, Kiwamu; Takahashi, Hiroomi; Shitara, Tetsuya

doi:10.2468/jbes.30.15

Cited by 1 publication

(1 citation statement)

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“…If the damage persists, it can lead to severe complications such as vascular ischemia, loss of ciliary activity, inflammation, ulceration, and tracheal stenosis [ 1 , 20 , 21 , 25 ]. To-oru et al and Donnely et al in their large number of post-mortem studies in cadavers showed that mucosal ulceration was present in the tracheal specimens they examined as early as 1 hour after intubation [ 26 , 27 ]. Less than 10% of those intubated for less than 24 hours, but almost all of those intubated for more than 48 hours, had deep ulceration.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Topical Benzydamine Hydrochloride and Cuff Pressure Monitorization on Postoperative Sore Throat Due to Intubation

Olgun Keleş,

Kaya

2024

Cureus

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Objective: Postoperative sore throat (POST) is the most common discomfort after endotracheal intubation. Damage to the tracheal mucosa caused by inappropriate endotracheal tube (ETT) cuff pressure has been shown as the major factor. Monitoring the ETT cuff pressure at a certain value reduces this damage. Benzydamine hydrochloride (BH) has proven to be effective on sore throat and studies have shown that it is also effective on POST. In this study, the efficacy of BH and ETT cuff pressure monitoring on POST was evaluated. Materials and methods: After ethics committee approval 210 patients in the ASA (American Society of Anesthesiologists) I-III risk group undergoing elective surgery were included in the study. Routine anesthesia monitoring, induction, and maintenance were provided. Patients were randomly divided into three groups. Thirty minutes before surgery, the posterior pharyngeal wall was sprayed with BH in group 1 and distilled water in groups 2 and 3. Intraoperatively, the first and second groups were monitored to keep the ETT cuff pressure between 22 and 26 cmH 2 O, while no intervention was performed in the third group. The incidence and severity of postoperative dysphagia, hoarseness, and POST were questioned. Results: There was no difference between demographic data, and gender was not associated with POST. There was a statistically significant difference between the first and second groups and the third group in terms of all three symptoms questioned (p<0.01). No difference was observed between the first and second groups. Side effect rates were similar. Smoking was not found to be associated with symptoms. Conclusion: The incidence and severity of POST, dysphagia, and hoarseness are reduced when the ETT cuff is inflated with a pressure of 22-26 cmH 2 O after intubation with a manometer and maintained at this pressure range throughout the operation. There was no beneficial effect of BH.

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