Effects of different deflation modes for endotracheal tube cuff on coughing response and hemodynamics during extubation
- VernacularTitle:气管导管套囊不同放气方式对拔管期呛咳反应及血流动力学的影响
- Author:
Yanlong YU
1
;
Xinqi ZHANG
;
Hu LI
;
Ning LI
;
Bo YUAN
;
Chao CHEN
;
Zhuan ZHANG
Author Information
- Keywords: endotracheal tube; cuff; pressure; extubation; coughing; hemodynamics
- From: Journal of Clinical Medicine in Practice 2024;28(9):15-19,24
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the effects of different deflation methods of endotracheal tube cuff on coughing response and hemodynamics during extubation.Methods Ninety patients un-dergoing elective surgery for endotracheal intubation under general anesthesia were selected as study subjects and randomly divided into study group and control group,with 45 patients in each group.In the study group,the cuff end of the endotracheal tube cuff was connected to a syringe and a non-liq-uid pressure gauge through a three-way stopcock.Before extubation,the cuff was aspirated to de-crease the cuff pressure at a rate of 3 cmH2O/s.In the control group,the gas in cuff was rapidly de-flated by aspirating all the gas inside with a syringe during extubation.The incidence and severity of coughing response during extubation were recorded in both groups.Mean arterial pressure(MAP)and heart rate(HR)were recorded before induction of general anesthesia(T0),before cuff deflation(T1),immediately after cuff deflation(T2),1 minute after extubation(T3),3 minutes after extuba-tion(T4),and 5 minutes after extubation(T5).Adverse events were also recorded in both groups.Results The coughing response during extubation started immediately after cuff deflation in both groups.The incidence and severity of coughing response were lower in the study group than in the control group(P＜0.05).Compared with the control group,values of MAP were lower at T2 to T4 and values of HR were lower at T2 to T5 in the study group(P＜0.05).The incidence of post-extubation pha-ryngeal discomfort was 6.67％in the study group,which was lower than 26.67％in the control group(P＜0.05).There was no significant difference in the incidence of post-extubation hypoventi-lation between the two groups(P＞0.05).Conclusion The method of slowly reducing the pres-sure of the endotracheal tube cuff at a constant rate can reduce the incidence and severity of coug-hing,decrease postoperative extubation complications,and stabilize hemodynamics,with better effects than the method of rapidly aspirating all the gas inside the cuff at once.
