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Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery

Year 2021, Volume: 34 Issue: 2, 140 - 146, 31.05.2021
https://doi.org/10.5472/marumj.942649

Abstract

Objective: We compared the air or saline insufflated endotracheal tube (ETT) cuff pressures and their effects on postoperative
respiratory complications in gynecological laparoscopic surgeries in the Trendelenburg position (TP).
Patients and Methods: This prospective study was carried out on a total of 60 patients, whose ages ranged from 18 to 65 years and
who were classified by the American Society of Anesthesiologists (ASA) as I-III. They were scheduled for gynecological laparoscopic
surgery in TP. Patients included in the study were randomly divided into two groups as the saline (Group S, n=30) and air (Group A,
n=30) groups. ETT cuff pressures and peak airway pressures were recorded immediately after intubation and at 10-minute intervals
during the intraoperative period.
Results: The cuff pressure and maximum cuff pressure values in the saline group were significantly lower than in the air group in
the 50-minute (p<0.05). The sore throat and analgesic consumption were significantly lower in Group S in postoperative 24 hours
(p<0.001, for all).
Conclusion: The intraoperative cuff pressures, postoperative sore throat, and analgesic consumption were lower in the salineinsufflated
group than in the air-insufflated group in gynecological laparoscopic surgery in TP.

References

  • Morgan GE, Mikhail MS, Murray MJ, editors. Clinical Anesthesiology 5th ed.International Edition: New York: Lange Medical Books, 2015:309-41.
  • Atlas GM. A mathematical model of differential tracheal tube cuff pressure: effects of diffusion and temperature. J Clin Monit Comput 2005;19:415-25. doi: 10.1007/s10877.005.1626-5.
  • Girling KJ, Bedforth NM, Spendlove JL, Mahajan RP. Assessing neuromuscular block at the larynx: the effect of change in resting cuff pressure and a comparison with video imaging in anesthetized humans. Anesth Analg 1999;88:426- 31. doi: 10.1097/00000.539.199902000-00038.
  • Godoy AC, Vieira RJ, Capitani EM. Endotracheal tube cuff pressure alteration after changes in position in patients under mechanical ventilation. J Bras Pneumol 2008;34:294-97. doi: 10.1590/s1806.371.3200800.050.0008.
  • Hameed AA, Mohamed H, Al-Mansoori M. Acquired tracheoesophageal fistula due to high intracuff pressure. Ann Thorac Med 2008;3:23-5. doi: 10.4103/1817-1737.37950.
  • Harris R, Joseph A. Acute tracheal rupture related to endotracheal intubation: case report. J Emerg Med 2000;18:35- 9. doi: 10.1016/s0736-4679(99)00159-6.
  • Pookamala S, Thakar A, Puri K, Singh P, Kumar R, Sharma SC. Acquired subglottic stenosis: aetiological profile and treatment results. J Laryngol Otol 2014;128:641-8. doi: 10.1017/S002.221.5114000966.
  • Touat L, Fournier C, Ramon P, Salleron J, Durocher A, Nseir S. Intubation-related tracheal ischemic lesions: incidence, risk factors, and outcome. Intensive Care Med 2013;39:575-82. doi: 10.1007/s00134.012.2750-6.
  • Rosero EB, Ozayar E, Eslava-Schmalbach J, Minhajuddin A, Joshi GP. Effects of increasing airway pressures on the pressure of the endotracheal tube cuff during pelvic laparoscopic surgery. Anesth Analg 2018;127:120-5. doi: 10.1213/ ANE.000.000.0000002657.
  • American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital – acquired, ventilator-associated, and healthcareassociated pneumonia. Am J Respir Crit Care Med 2005;171:388-416. doi: 10.1164/rccm.200405-644ST.
  • Bernhard WN, Yost L, Joynes D, Cothalis S, Turndorf H. Intracuff pressures in endotracheal and tracheostomy tubes. Related cuff physical characteristics. Chest 1985;87:720-5. doi: 10.1378/chest.87.6.720.
  • Diaz E, Rodríguez AH, Rello J. Ventilator-associated pneumonia: issues related to the artificial airway. Respir Care 2005;50:900-6.
  • Nordin U. The trachea and cuff-induced tracheal injury. An experimental study on causative factors and prevention. Acta Otolaryngol Suppl 1977;345:1-71.
  • Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed). 1984;288:965- 8. doi: 10.1136/bmj.288.6422.965.
  • Geng G, Hu J, Huang S. The effect of endotracheal tube cuff pressure change during gynecological laparoscopic surgery on postoperative sore throat: a control study. Journal of Clin Monit Comput 2015;29:141-4. doi: 10.1007/s10877.014.9578- 2.
  • Wu CY, Yeh YC, Wang MC, Lai CH, Fan SZ. Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down position. BMC Anesthesiology 2014 31;14:75. eCollection 2014. doi: 10.1186/1471-2253-14-75.
  • Farhang, B, Grondin, L. The effect of zinc lozenge on postoperative sore throat: a prospective randomized, doubleblinded, placebo-controlled study. Anesthesia & Analgesia 2018; 126:78-83. doi: 10.1213/ANE.000.000.0000002494.
  • Kuriyama, A, Maeda, H, Sun, R, Aga, M. Topical application of corticosteroids to tracheal tubes to prevent postoperative sore throat in adults undergoing tracheal intubation: a systematic review and meta‐analysis. Anaesthesia 2018;73:1546-56. doi: 10.1111/anae.14273.
  • Sanaie S, Rahmani F, Chokhachian S, et al. Comparison of tracheal tube cuf pressure with two technique: fxed volume and minimal leak test techniques. J Cardiovasc Thorac Res. 2019;11:48–52. doi: 10.15171/jcvtr.2019.08.
  • Aldrete JA. Post-anesthesia recovery score revisited. J Clin Anesth 1995;7:89-91. doi: 10.1016/0952-8180(94)00001-K
  • Mol DA, De Villers Gdu T, Claassen AJ, Joubert G. Use and care of an endotracheal/tracheostomy tube cuff-are intensive care unit staff adequately informed? S Afr J Surg 2004;42:14-6.
  • Liu J, Zhang X, Gong W et al. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: A multicenter study. Anesth Analg 2010;111:1133-7. doi: 10.1213/ANE.0b013e3181f2ecc7.
  • Rello, J, Sonora, R, Jubert, P, Artigas, A, Rué, M, Vallés, J. Pneumonia in intubated patients: role of respiratory airway care. Am J Respir Crit Care Med 1996;154:111-5. doi: 10.1164/ ajrccm.154.1.8680665.
  • Jaensson M, Gupta A, Nilsson UG. Gender differences in risk factors for airway symptoms following tracheal intubation. Acta Anaesthesiol Scand 2012;56:1306-13. doi: 10.1111/j.1399- 6576.2012.02771.x.
  • Cakmakkaya, O. S, Kaya, G, Altintas, F, Hayirlioglu, M, Ekici, B. Restoration of pulmonary compliance after laparoscopic surgery using a simple alveolar recruitment maneuver. J Clin Anesth 2009;21:422-6. doi: 10.1016/j.jclinane.2009.08.001.
  • Yildirim Z B, Uzunkoy A, Cigdem A, Ganidagli S, Ozgonul A. Changes in cuff pressure of endotracheal tube during laparoscopic and open abdominal surgery. Surg Endosc 2012; 26:398-401. doi: 10.1007/s00464.011.1886-8.
  • Gerges FJ, Kanazi GE, Jabbour-Khoury SI. Anesthesia for laparoscopy: a review. J Clin Anesth 2006;18:67-78. doi: 10.1016/j.jclinane.2005.01.013.
  • Kwon Y, Jang J S, Hwang S M, et al. The change of endotracheal tube cuff pressure during laparoscopic surgery. Open Medicine 2019;14:431-6. doi: 10.1515/med-2019-0046.
  • Estebe JP, Delahaye S, Le Corre P, et al. Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena. Br J Anaesth 2004;92:361-6. doi: 10.1093/bja/aeh078.
  • Chang J E, Kim H, Han S H, Lee J M, Ji S, Hwang J Y. Effect of endotracheal tube cuff shape on postoperative sore throat after endotracheal intubation. Anesthesia & Analgesia 2017; 125:1240-5. doi: 10.1213/ANE.000.000.0000001933.
  • Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U. Ketamine gargle for attenuating postoperative sore throat. Br J Anaesth 2008;100:490-3. doi: 10.1093/bja/aen023.
  • Halliday D, Resnick R, Walker J. Fundamentals of physics. New York, NY, Wiley, 2001.
  • Ahmad N L, Norsidah A M. Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: A comparison between air and distilled water cuff inflation Anaesthesia and Intensive Care 2001;29:510-4. doi: 10.1177/0310057X010.290.0511.
  • Beşir A, Erdoğan G. Comparison between cuff pressures of endotracheal tubes inflated with saline or air in low-flow anesthesia. Clin Exp Health Sci 2018; 8:112-7. doi:10.5152/ clinexphealthsci.2017.537.
  • Shroff PP, Patil V. Efficacy of cuff inflation media to prevent postintubation-related emergence phenomenon: air, saline and alkalinized lignocaine. Eur J Anaesthesiol 2009;26:458- 62. doi: 10.1097/eja.0b013e32832403fa.
  • Kumar S P, Ravikumar A. Biometric study of the internal dimensions of subglottis and upper trachea in adult Indian population. Indian Journal of Otolaryngol Head Neck Surg 2014;66:261-6. doi: 10.1007/s12070.012.0477-x.
Year 2021, Volume: 34 Issue: 2, 140 - 146, 31.05.2021
https://doi.org/10.5472/marumj.942649

Abstract

References

  • Morgan GE, Mikhail MS, Murray MJ, editors. Clinical Anesthesiology 5th ed.International Edition: New York: Lange Medical Books, 2015:309-41.
  • Atlas GM. A mathematical model of differential tracheal tube cuff pressure: effects of diffusion and temperature. J Clin Monit Comput 2005;19:415-25. doi: 10.1007/s10877.005.1626-5.
  • Girling KJ, Bedforth NM, Spendlove JL, Mahajan RP. Assessing neuromuscular block at the larynx: the effect of change in resting cuff pressure and a comparison with video imaging in anesthetized humans. Anesth Analg 1999;88:426- 31. doi: 10.1097/00000.539.199902000-00038.
  • Godoy AC, Vieira RJ, Capitani EM. Endotracheal tube cuff pressure alteration after changes in position in patients under mechanical ventilation. J Bras Pneumol 2008;34:294-97. doi: 10.1590/s1806.371.3200800.050.0008.
  • Hameed AA, Mohamed H, Al-Mansoori M. Acquired tracheoesophageal fistula due to high intracuff pressure. Ann Thorac Med 2008;3:23-5. doi: 10.4103/1817-1737.37950.
  • Harris R, Joseph A. Acute tracheal rupture related to endotracheal intubation: case report. J Emerg Med 2000;18:35- 9. doi: 10.1016/s0736-4679(99)00159-6.
  • Pookamala S, Thakar A, Puri K, Singh P, Kumar R, Sharma SC. Acquired subglottic stenosis: aetiological profile and treatment results. J Laryngol Otol 2014;128:641-8. doi: 10.1017/S002.221.5114000966.
  • Touat L, Fournier C, Ramon P, Salleron J, Durocher A, Nseir S. Intubation-related tracheal ischemic lesions: incidence, risk factors, and outcome. Intensive Care Med 2013;39:575-82. doi: 10.1007/s00134.012.2750-6.
  • Rosero EB, Ozayar E, Eslava-Schmalbach J, Minhajuddin A, Joshi GP. Effects of increasing airway pressures on the pressure of the endotracheal tube cuff during pelvic laparoscopic surgery. Anesth Analg 2018;127:120-5. doi: 10.1213/ ANE.000.000.0000002657.
  • American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital – acquired, ventilator-associated, and healthcareassociated pneumonia. Am J Respir Crit Care Med 2005;171:388-416. doi: 10.1164/rccm.200405-644ST.
  • Bernhard WN, Yost L, Joynes D, Cothalis S, Turndorf H. Intracuff pressures in endotracheal and tracheostomy tubes. Related cuff physical characteristics. Chest 1985;87:720-5. doi: 10.1378/chest.87.6.720.
  • Diaz E, Rodríguez AH, Rello J. Ventilator-associated pneumonia: issues related to the artificial airway. Respir Care 2005;50:900-6.
  • Nordin U. The trachea and cuff-induced tracheal injury. An experimental study on causative factors and prevention. Acta Otolaryngol Suppl 1977;345:1-71.
  • Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed). 1984;288:965- 8. doi: 10.1136/bmj.288.6422.965.
  • Geng G, Hu J, Huang S. The effect of endotracheal tube cuff pressure change during gynecological laparoscopic surgery on postoperative sore throat: a control study. Journal of Clin Monit Comput 2015;29:141-4. doi: 10.1007/s10877.014.9578- 2.
  • Wu CY, Yeh YC, Wang MC, Lai CH, Fan SZ. Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down position. BMC Anesthesiology 2014 31;14:75. eCollection 2014. doi: 10.1186/1471-2253-14-75.
  • Farhang, B, Grondin, L. The effect of zinc lozenge on postoperative sore throat: a prospective randomized, doubleblinded, placebo-controlled study. Anesthesia & Analgesia 2018; 126:78-83. doi: 10.1213/ANE.000.000.0000002494.
  • Kuriyama, A, Maeda, H, Sun, R, Aga, M. Topical application of corticosteroids to tracheal tubes to prevent postoperative sore throat in adults undergoing tracheal intubation: a systematic review and meta‐analysis. Anaesthesia 2018;73:1546-56. doi: 10.1111/anae.14273.
  • Sanaie S, Rahmani F, Chokhachian S, et al. Comparison of tracheal tube cuf pressure with two technique: fxed volume and minimal leak test techniques. J Cardiovasc Thorac Res. 2019;11:48–52. doi: 10.15171/jcvtr.2019.08.
  • Aldrete JA. Post-anesthesia recovery score revisited. J Clin Anesth 1995;7:89-91. doi: 10.1016/0952-8180(94)00001-K
  • Mol DA, De Villers Gdu T, Claassen AJ, Joubert G. Use and care of an endotracheal/tracheostomy tube cuff-are intensive care unit staff adequately informed? S Afr J Surg 2004;42:14-6.
  • Liu J, Zhang X, Gong W et al. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: A multicenter study. Anesth Analg 2010;111:1133-7. doi: 10.1213/ANE.0b013e3181f2ecc7.
  • Rello, J, Sonora, R, Jubert, P, Artigas, A, Rué, M, Vallés, J. Pneumonia in intubated patients: role of respiratory airway care. Am J Respir Crit Care Med 1996;154:111-5. doi: 10.1164/ ajrccm.154.1.8680665.
  • Jaensson M, Gupta A, Nilsson UG. Gender differences in risk factors for airway symptoms following tracheal intubation. Acta Anaesthesiol Scand 2012;56:1306-13. doi: 10.1111/j.1399- 6576.2012.02771.x.
  • Cakmakkaya, O. S, Kaya, G, Altintas, F, Hayirlioglu, M, Ekici, B. Restoration of pulmonary compliance after laparoscopic surgery using a simple alveolar recruitment maneuver. J Clin Anesth 2009;21:422-6. doi: 10.1016/j.jclinane.2009.08.001.
  • Yildirim Z B, Uzunkoy A, Cigdem A, Ganidagli S, Ozgonul A. Changes in cuff pressure of endotracheal tube during laparoscopic and open abdominal surgery. Surg Endosc 2012; 26:398-401. doi: 10.1007/s00464.011.1886-8.
  • Gerges FJ, Kanazi GE, Jabbour-Khoury SI. Anesthesia for laparoscopy: a review. J Clin Anesth 2006;18:67-78. doi: 10.1016/j.jclinane.2005.01.013.
  • Kwon Y, Jang J S, Hwang S M, et al. The change of endotracheal tube cuff pressure during laparoscopic surgery. Open Medicine 2019;14:431-6. doi: 10.1515/med-2019-0046.
  • Estebe JP, Delahaye S, Le Corre P, et al. Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena. Br J Anaesth 2004;92:361-6. doi: 10.1093/bja/aeh078.
  • Chang J E, Kim H, Han S H, Lee J M, Ji S, Hwang J Y. Effect of endotracheal tube cuff shape on postoperative sore throat after endotracheal intubation. Anesthesia & Analgesia 2017; 125:1240-5. doi: 10.1213/ANE.000.000.0000001933.
  • Canbay O, Celebi N, Sahin A, Celiker V, Ozgen S, Aypar U. Ketamine gargle for attenuating postoperative sore throat. Br J Anaesth 2008;100:490-3. doi: 10.1093/bja/aen023.
  • Halliday D, Resnick R, Walker J. Fundamentals of physics. New York, NY, Wiley, 2001.
  • Ahmad N L, Norsidah A M. Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: A comparison between air and distilled water cuff inflation Anaesthesia and Intensive Care 2001;29:510-4. doi: 10.1177/0310057X010.290.0511.
  • Beşir A, Erdoğan G. Comparison between cuff pressures of endotracheal tubes inflated with saline or air in low-flow anesthesia. Clin Exp Health Sci 2018; 8:112-7. doi:10.5152/ clinexphealthsci.2017.537.
  • Shroff PP, Patil V. Efficacy of cuff inflation media to prevent postintubation-related emergence phenomenon: air, saline and alkalinized lignocaine. Eur J Anaesthesiol 2009;26:458- 62. doi: 10.1097/eja.0b013e32832403fa.
  • Kumar S P, Ravikumar A. Biometric study of the internal dimensions of subglottis and upper trachea in adult Indian population. Indian Journal of Otolaryngol Head Neck Surg 2014;66:261-6. doi: 10.1007/s12070.012.0477-x.
There are 36 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Selin Sahın This is me 0000-0002-7925-6433

Ahmet Besir This is me 0000-0001-6059-4347

Ali Akdogan This is me 0000-0001-7592-3844

Ersagun Tugcugıl This is me 0000-0002-1963-2206

Sedat Saylan This is me 0000-0002-4833-9455

Publication Date May 31, 2021
Published in Issue Year 2021 Volume: 34 Issue: 2

Cite

APA Sahın, S., Besir, A., Akdogan, A., Tugcugıl, E., et al. (2021). Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery. Marmara Medical Journal, 34(2), 140-146. https://doi.org/10.5472/marumj.942649
AMA Sahın S, Besir A, Akdogan A, Tugcugıl E, Saylan S. Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery. Marmara Med J. May 2021;34(2):140-146. doi:10.5472/marumj.942649
Chicago Sahın, Selin, Ahmet Besir, Ali Akdogan, Ersagun Tugcugıl, and Sedat Saylan. “Comparison of Endotracheal Tube Cuff Pressures Inflated With Saline or Air in Gynecological Laparoscopic Surgery”. Marmara Medical Journal 34, no. 2 (May 2021): 140-46. https://doi.org/10.5472/marumj.942649.
EndNote Sahın S, Besir A, Akdogan A, Tugcugıl E, Saylan S (May 1, 2021) Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery. Marmara Medical Journal 34 2 140–146.
IEEE S. Sahın, A. Besir, A. Akdogan, E. Tugcugıl, and S. Saylan, “Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery”, Marmara Med J, vol. 34, no. 2, pp. 140–146, 2021, doi: 10.5472/marumj.942649.
ISNAD Sahın, Selin et al. “Comparison of Endotracheal Tube Cuff Pressures Inflated With Saline or Air in Gynecological Laparoscopic Surgery”. Marmara Medical Journal 34/2 (May 2021), 140-146. https://doi.org/10.5472/marumj.942649.
JAMA Sahın S, Besir A, Akdogan A, Tugcugıl E, Saylan S. Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery. Marmara Med J. 2021;34:140–146.
MLA Sahın, Selin et al. “Comparison of Endotracheal Tube Cuff Pressures Inflated With Saline or Air in Gynecological Laparoscopic Surgery”. Marmara Medical Journal, vol. 34, no. 2, 2021, pp. 140-6, doi:10.5472/marumj.942649.
Vancouver Sahın S, Besir A, Akdogan A, Tugcugıl E, Saylan S. Comparison of endotracheal tube cuff pressures inflated with saline or air in gynecological laparoscopic surgery. Marmara Med J. 2021;34(2):140-6.