Does the Continuous Monitoring and Regulation of the Endotracheal Tube Cuff Pressure Alone Decrease the Incidence and Severity of Postoperative Laryngotracheal Discomforts after Nitrous Oxide Anesthesia?

Abstract

Background and Objective: Laryngotracheal discomforts are common in intubated patients after nitrous oxide anesthesia, due to increased endotracheal tube cuff pressure (intracuff pressure) during the intraoperative period. The aim of this study was to compare the incidence and severity of postoperative laryngotracheal discomforts between intraoperatively uncontrolled and controlled intracuff pressure between 20-25 mm.Hg.

Methods: One hundred and forty four patients, ASA physical status I-II who scheduled for elective surgery and received balanced general anesthesia with 67% nitrous oxide in oxygen, were randomly allocated to two groups. The endotracheal tube cuff was inflated with air in both groups to achieve     a pressure of 20 mm.Hg. In control group (n=72), the cuff remained unmanipulated, whereas in study group (n=72), the intracuff pressure was controlled intraoperatively between 20-25 mm.Hg. Laryngotracheal discomforts were assessed using numeric rating scale (NRS) at ward 12-24 hours postoperatively.

Results: The incidence and severity of postoperative laryngotracheal discomforts in both groups were not different (p>0.05).

Conclusion: Intraoperatively controlled intracuff pressure during nitrous oxide anesthesia alone did not decrease postoperative laryngotracheal discomforts.

Key Words: postoperative laryngotracheal discomforts, sore throat, hoarseness, dysphagia, intracuff pressure