The effect of endotracheal tube cuff pressure control on postextubation throat pain in orthognathic surgeries: a randomized double-blind controlled clinical trial

Ansari, Ladan; Bohluli, Behnam; Mahaseni, Hamidreza; Naser, Valaei; Sadr-Eshkevari, Pooyan; Rashad, Ashkan

doi:10.1016/j.bjoms.2013.10.005

Cited by 21 publications

(21 citation statements)

References 28 publications

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“…Smaller tube size [5][6][7] Use of i-gel [50,[63][64][65] SAD rather than tracheal tube [121,122] Video laryngoscopy [9,10] 90°rotational insertion technique, use of introducing stylet for ProSeal LMA laryngeal mask [81][82][83][84][85] Oral rather than nasotracheal intubation [124] Limiting cuff pressure [32][33][34] Cuff pressure limitation ≤ 60 cmH 2 O [88][89][90][91][92][93]96] Cuffed rather than uncuffed tubes [125] Intravenous, topical or inhaled steroids [22][23][24][25] Topical steroids, NSAIDs, tramadol [98,101,102] Limiting tracheal tube cuff pressure [126] Topical NSAIDs [27][28][29]31] Propofol induction and maintenance [106,107] SAD cuff pressure limitation ≤ 60 cmH 2 O [130][131][132][133] Liquorice, magnesium and ketami...…”

Section: Tracheal Intubation Sads Childrenmentioning

confidence: 99%

Postoperative sore throat: a systematic review

2016

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Summary Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre‐existing lung disease, prolonged duration of anaesthesia and the presence of a blood‐stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double‐lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i‐gel™ supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence.

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Section: Tracheal Intubation Sads Childrenmentioning

confidence: 99%

Postoperative sore throat: a systematic review

2016

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“…Specific details for selected studies are shown in Table 2. Studies were in either adult tertiary intensive care settings (2) 52,53 , operating theatre (6) [45][46][47][48][49][50] , both operating theatre and intensive care setting 47 , or intubated in medical wards (1) 51 . Mean age overall was 43 years (range .…”

Section: Demographics and Settingmentioning

confidence: 99%

“…Three studies 46,48,49 found significantly increased incidence of sore throat in the control group at 24 hours (OR 0.55, CI 0.41 to 0.75, P=0.00). Another study established pain by the visual analog scale (VAS) and found a significantly greater score for pain at two and six hours but not at 24 hours 45 ( Table 4). One study investigated dysphagia at two and 24 hours and found no difference between groups 48 (Table 4).…”

Section: Sore Throat Pain and Dysphagiamentioning

confidence: 99%

Does Objective Measurement of Tracheal Tube Cuff Pressures Minimise Adverse Effects and Maintain Accurate Cuff Pressures? A Systematic Review and Meta-Analysis

Hockey

Zundert

Paratz

2016

Anaesth Intensive Care

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Correct inflation pressures of the tracheal cuff are recommended to ensure adequate ventilation and prevent aspiration and adverse events. However there are conflicting views on which measurement to employ. The aim of this review was to examine whether adjustment of cuff pressure guided by objective measurement, compared with subjective measurement or observation of the pressure value alone, was able to prevent patient-related adverse effects and maintain accurate cuff pressures. A search of PubMed, Web of Science, Embase, CINAHL and ScienceDirect was conducted using keywords 'cuff pressure' and 'measure*' and related synonyms. Included studies were randomised or pseudo-randomised controlled trials investigating mechanically ventilated patients both in the intensive care unit and during surgery. Outcomes included adverse effects and the comparison of pressure measurements. Pooled analyses were performed to calculate risk ratios, effect sizes and 95% confidence intervals. Meta-analysis found preliminary evidence that adjustment of cuff pressure guided by objective measurement as compared with subjective measurement or observation of the pressure value alone, has benefit in preventing adverse effects. These included cough at two hours (odds ratio [OR] 0.42, confidence interval [CI] 0.23 to 0.79, P=0.007), hoarseness at 24 hours (OR 0.49, CI 0.31 to 0.76, P <0.002), sore throat (OR 0.73, CI 0.54 to 0.97, P <0.03), lesions of the trachea and incidences of silent aspiration (P=0.001), as well as maintaining accurate cuff pressures (Hedges' g 1.61, CI 2.69 to 0.53, P=0.003). Subjective measurement to guide adjustment or observation of the pressure value alone may lead to patient-related adverse effects and inaccuracies. It is recommended that an objective form of measurement be used.

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“…Nasotracheal intubation is often used in oromaxillofacial surgery patients [10][11][12]. During nasotracheal intubation, the tube tip may catch on the anterior wall of the trachea immediately after passing the glottis.…”

Section: Discussionmentioning

confidence: 99%