Sore Throat After Operation: Influence of Tracheal Intubation, Intracuff Pressure and Type of Cuff

Abstract

One hundred and eighty-four patients were studied to elucidate the contribution of intracuff pressure and cuff type to the occurrence of sore throat and hoarseness after operation. The patients were allocated to one of the following groups: A = mask only; B = reusable Rüsch tube with intermittent cuff volume adjustment; C = reusable Rüsch tube without cuff volume adjustment; D = disposable Portex Blue Line tube with intermittent cuff volume adjustment; E = disposable Shiley Low Pressure tube with intermittent cuff volume adjustment. Nitrous oxide was a component of anaesthesia in all patients. Moderate or severe symptoms were recorded in 30-33% of the patients in groups C, D and E, contrasting with group B, in which these sequelae were seen in only 10% of patients (P less than 0.025). All sequelae occurred less frequently in group A than in any of the other groups (P less than 0.025). Women were more likely to develop sore throat after intubation than were men (P less than 0.01). A possible relationship between differences in cuff-trachea contact area is postulated.

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

“…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]. These data are comparable with the incidence of sore throat in anaesthetised unintubated patients [13]. The incidence of sore throat does appear to decrease with increased clinical experience in using the LMA [7].…”

Assessment of the efficacy of dexamethasone, lignocaine or placebo in the prevention of post intubation sore throat

“…Christinestock & John Downs [3] found no significant difference in the incidence or severity of sore throats based on the type of lubricant used on the tracheal tube or based on the presence or absence of lignocaine in the lubricant. In fact there was no difference in the incidence or severity of sore throat in patients who were intubated with dry tubes compared with those intubated with lubricated tubes [2].…”

“…b) Bulkier and larger low pressure tubes produce more damage to upper airway structures on intubation or extubation c) Low pressure high volume tube cuffs produce grooves in the mucosa because of wrinkling of the cuffs as it is inflated, unlike the inflation of high pressure low volume cuffs [16]. Edward loeser et al [11] demonstrated that low pressure high volume endotracheal tube cuffs IJBR (2015) 6 (07) www.ssjournals.com…”

“…Use of highpressure low-volume cuff endotracheal tube resulted in an incidence and severity of postoperative sore throat no significantly different from the incidence and severity in patients whose tracheas were not intubated. When intracuff pressure in the low volume high pressure cuffed tubes was high and allowed to increase the advantage of decreased incidence of sore throat is lost [2]. Although the high volume cuffs caused a greater area of damage to the tracheal mucosa, the damage was more superficial than that caused by the high pressure cuffs [22].…”

“…The patient notices symptoms, which include difficulty in swallowing, sore throat, hoarseness and aphonia even though these are all minor complications of endotracheal anaesthesia. The incidence of sore throat may be up to 90% depending on the institution [1][2][3][4][5][6].…”