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Comparison of the endotracheal cuff inflation techniques and its postoperative laryngotracheal morbidity: an observational study

Mali, Ashish Solanki, Jinal Ashok Deshpande, Charulata M.
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    Background: Endotracheal tubes cuffs are used to prevent gas leak and also pulmonary aspiration in mechanically ventilated patients. The commonly employed intubation techniques are the use of inflation to a constant pressure (25 cm H2O), sealing pressure and estimation of the cuff pressure by finger palpation. However, the use of the cuff inflation volumes may cause tracheal morbidity. The aim of the present study was to compare the effective tracheal seal and the incidence of post-intubation airway complications between the three techniques.Methods: 90 patients under N2O free general endotracheal anaesthesia were included in the study. They were randomly allotted into three groups consisting of 30 in each. After induction of anesthesia, endotracheal tubes size 7.0 mm for female and 8.5 mm for male were used. Constant pressure group (n=30), the cuff was inflated to a pressure of 25 cm H2O; sealing group (n=30), the cuff was inflated to prevent air leaks at airway pressure of 20 cm H2O and finger group (n=30), the cuff was inflated using finger estimation. Manometric cuff pressure and volume of air required to inflate the cuff, incidence of sore throat, hoarseness and dysphagia were tested.Results: Significant differences was not observed between the three groups in case of demographic data, ASA grading, endotracheal tube size used, number of attempts to place the endotracheal tubes, duration of intubation between the three groups. On the other hand, the cuff pressure, volume of air to fill the cuff and the incidence of sore throat was significantly higher in the finger group compared to other two groups (p ≤0.05). The incidence of dysphagia and hoarseness was also higher in finger palpitation group but the difference is insignificant.Conclusions: In cases of N2O free anesthesia, sealing cuff pressure is an easy and safe alternative technique compared to other two techniques, regarding effectiveness and low incidence of tracheal morbidities.


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