Comparison of the endotracheal tube intracuff pressure with cylindrical and tapered cuffs during nitrous oxide exposure: a randomized single-blinded clinical study.
10.17085/apm.2017.12.3.275
- Author:
Ha Yeon PARK
1
;
Daehwan KIM
;
Junyong IN
Author Information
1. Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea. dragona1@dumc.or.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Airway management;
Intratracheal intubation;
Nitrous oxide
- MeSH:
Airway Management;
Anesthesia;
Anesthesia, General;
Clinical Study*;
Diffusion;
Humans;
Intubation, Intratracheal;
Nitrous Oxide*;
Supine Position
- From:Anesthesia and Pain Medicine
2017;12(3):275-280
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Tracheal complications caused by excessive mucosal pressure from an inflated endotracheal tube are major concerns during anesthesia; hence, an intracuff pressure of 20–30 cmH₂O is recommended as a clinically acceptable intracuff pressure. Diffusion of nitrous oxide (N₂O) into the endotracheal tube cuff increases the intracuff pressure, which may also be influenced by the cuff shape. Therefore, we investigated whether the intracuff pressure of a tapered cuff was different from that of a cylindrical cuff in patients undergoing general anesthesia using 60% N₂O. METHODS: Twenty-six patients who underwent general anesthesia using 60% N₂O in supine position were randomly allocated to the cylindrical cuff group (Group C) or tapered cuff group (Group T). The baseline intracuff pressure was set at 20 cmH₂O, and measured every 10 minutes for 60 minutes. RESULTS: The primary outcome was the intracuff pressure at 60 minutes after N₂O exposure, which was 40 cmH₂O in Group C (95% CI 36–44) and 40 cmH₂O (95% CI 35–45) in Group T (P = 0.895). The lower confidence limit of the intracuff pressures in both groups exceeded 30 cmH₂O at 60 minutes of N₂O exposure, which is the upper limit for clinically acceptable intracuff pressure (20–30 cmH₂O). CONCLUSIONS: There was no significant difference in the intracuff pressures between cylindrical and tapered cuffs. Continuous or frequent monitoring is recommended regardless of the duration of the 60% N₂O exposure because the intracuff pressure can exceed 30 cmH₂O within an hour.
