Maintaining endotracheal tube cuff pressure at 20 mmHg during anterior cervical spine surgery to prevent dysphagia: a double-blind randomized controlled trial

2018 ◽  
Vol 28 (2) ◽  
pp. 353-361
Author(s):  
Bastiaan A. in ’t Veld ◽  
Thijs C. D. Rettig ◽  
Naomi de Heij ◽  
Jessica de Vries ◽  
Jasper F. C. Wolfs ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cuff Pressure ◽  
Controlled Trial ◽  
Endotracheal Tube Cuff ◽  
Double Blind ◽  
Tube Cuff ◽  
Cervical Spine Surgery ◽  
Randomized Controlled ◽  
Anterior Cervical Spine Surgery ◽  
Endotracheal Tube Cuff Pressure

scholarly journals Intraoperative Measurement of Endotracheal Tube Cuff Pressure and Its Change During Surgery in Correlation With Recurrent Laryngeal Nerve Palsies, Hoarseness, and Dysphagia After Anterior Cervical Discectomy and Fusion: A Prospective Randomized Controlled Trial

2021 ◽  
pp. 219256822110468
Author(s):  
Alena Sejkorová ◽  
Martin Bolcha ◽  
Jan Beneš ◽  
Jiří Kalhous ◽  
Martin Sameš ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Controlled Trial ◽  
Laryngeal Nerve ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Endotracheal Tube Cuff Pressure

Study Design Prospective randomized controlled trial. Objectives Adjustment of endotracheal tube cuff pressure (ETCP) in anterior cervical discectomy and fusion (ACDF) may influence the incidence of complications such as recurrent laryngeal nerve palsy (RLNP), hoarseness, and dysphagia. Methods The prospective randomized controlled trial was designed to investigate the influence of ETCP on the incidence of postoperative complications. All eligible patients underwent vocal cord examination before and after ACDF and were randomized into a control group (CG) and intervention group (IG). Endotracheal tube cuff pressure was passively monitored in CG, and in IG, it was maintained at 20 mmHg. Outcomes were evaluated during hospitalization and during follow-up. Results A total of 98 patients were randomized, each group consisted of 49 patients. Statistical analysis showed that gender and age did not influence the incidence of complications. In CG, duration of retractor placement and extent of approach significantly impacted the occurrence of complications. The incidence of postoperative RLNP was 8.2% in IG and 12.2% in CG, hoarseness and dysphonia were present in 18.4% in IG and in 37.5% in CG, and dysphagia in 20.8% in IG and in 22.5% in CG. Hoarseness was significantly present more in CG ( P = .018). Only one patient from CG presented with RLNP after 1 year, the remaining nine patients spontaneously recovered. Conclusions Unregulated ETCP can lead to a significantly higher incidence of hoarseness; however, its improvement rate is 100%. The early postoperative complication rate was higher in CG, and after one year, 1 patient had RLNP and 1 patient had dysphagia.

scholarly journals The Effect of Adjustment of Endotracheal Tube Cuff Pressure during Scarless Remote Access Endoscopic and Robotic Thyroidectomy on Laryngo-Pharyngeal Complications: Prospective Randomized and Controlled Trial

2019 ◽  
Vol 8 (11) ◽  
pp. 1787 ◽  
Author(s):  
Chang-Hoon Koo ◽  
Hye-Min Sohn ◽  
Eun-Su Choi ◽  
June-Yong Choi ◽  
Ah-Young Oh ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Controlled Trial ◽  
Robotic Thyroidectomy ◽  
Remote Access ◽  
Control Group ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Significant Difference ◽  
Endotracheal Tube Cuff Pressure

Scarless remote access endoscopic and robotic thyroidectomy has been recently performed as a safe and feasible method. However, little is known about the laryngo-pharyngeal complications after surgery and the effect of adjusting the endotracheal tube cuff pressure during surgery on laryngo-pharyngeal complications. Patients were randomized into two groups: the control group (n = 52) and adjusted group (n = 52). The initial cuff pressure was set to 25 mmHg and then monitored without adjustment (control group) or with adjustment at approximately 25 mmHg (adjusted group) throughout surgery. The incidences and severity of postoperative sore throat (POST), hoarseness, dysphagia, and cough were recorded at 1, 6, 24, and 48 h after surgery. Cuff pressures of the control group changed significantly over time and were higher than those of the adjusted group. The incidence of POST was lower in the adjusted group at 24 h postoperatively (p = 0.035), and there was a significant difference in the severity of POST at 6 and 24 h postoperatively between the two groups. There were no differences in the incidence of hoarseness, dysphagia, and cough between the two groups, except dysphagia and cough at 6 h postoperatively. Therefore, intraoperative monitoring and adjustment of the cuff pressure can reduce the incidence of laryngo-pharyngeal complications.

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