Background: Endotracheal tube cuff (ETTc) inflation pressure is usually not regarded as an important aspect during intubation. In this study, we compared measuring ETTc pressure and pilot balloon palpation method in causing post-operative airway complications. Methods: Two hundred and ninety-two surgical patients requiring intubation were recruited into this prospective, double-blind, randomised controlled study. Group A patients had their ETTc initially inflated, checked by a cuff pressure gauge, recorded and then set to 25 cmH2O. Group B patients had their ETTc inflated using the pilot balloon palpation method. Patients were then followed up for post-operative sore throat, hoarseness and cough. Results: The overall incidence of post-operative sore throat was 39.0% versus 75.3% (P < 0.001), hoarseness 6.2% versus 15.1% (P < 0.05) and cough 7.5% versus 21.9% (P < 0.05) in Group A and B, respectively. Group A patients experienced a significant reduction in the incidence and severity of sore throat up to 24 h post-operatively (P < 0.001), hoarseness at the first hour (P = 0.004) and cough at first and 12 h post-operatively (P = 0.002). Conclusion: Adjusting the ETTc pressure to 25 cmH2O reduces post-operative sore throat, hoarseness and cough compared to pilot balloon palpation method.

Introduction: Effective post-operative analgesia is a major factor in functional outcome after total knee arthroplasty (TKA). To reduce post-operative pain and expedite recovery, peripheral nerve blocks, such as the femoral nerve block (FNB) have been used as an adjunct to the analgesic regime. We assessed whether the addition of a FNB to continuous epidural analgesia (CEA) would improve pain control after TKA. Materials and Methods: A prospective, randomised, controlled study was conducted on 58 patients undergoing TKA and randomised into two groups. The CEA+FNB Group received a single-shot FNB of 30 ml 0.5% bupivacaine using a nerve stimulator technique. The CEA Group acted as a control group and did not receive FNB. Patients in both groups then received combined spinal-epidural anaesthesia for the surgery. Post-operative epidural infusion with 0.1% bupivacaine and 2 μg/ml of fentanyl, at 6 ml/hr was continued up to 48 hours post-operatively. Visual analogue scale (VAS) scores, motor blockade, requirement of rescue analgesia and patient satisfaction were recorded. : Results: VAS scores were not significantly different between the CEA+FNB and CEA groups during rest (3 vs. 2) and flexion (5 vs. 6) on postoperative day-1 and during rest (1 vs. 2) and flexion (4 vs. 4) on postoperative day-2. There was no significant difference in rescue analgesia required, the volume of epidural infusion, motor blockade or patient satisfaction between both groups. Conclusion We concluded that the addition of FNB to epidural infusion did not improve analgesia after TKA.