A COMPARATIVE ANALYSIS FOR REDUCTION OF POST-SURGICAL SORE THROAT BY APPLYING OF KETAMINE-NEBULIZATION & BETAMETHASONE-GEL OVER THE ENDO-TRACHEAL TUBE CUFF

Background: In general anaesthesia (GA), endo-tracheal -intubation is required to control respiration & to protect the airway. The commonest locations of injury while intubation are the larynx & trachea, which typically manifest as regional pain, inflammation & even necrosis. Aims & objectives: This research was carried out to contrast the efficaciousness of ketamine-nebulization & betamethasone-gel on the cuff of the endo-tracheal -tube to alleviate post-surgical throat pain (POST). Materials & methods: This is a randomized, prospective research assessing the efficaciousness of betamethasone-gel & lignocaine-jelly ketamine-nebulisation applied over the endo-tracheal -tube cuff to decrease post-surgical sore throat nebulisation (POST). The study subjects were divided randomly into ketamine (category K), betamethasone (category B) & lignocaine category (category L). Study subjects were observed immediately after extubation (0 hr), 2 hrs, 6 hrs, 12 hrs & 24 hours after the post-surgical time for POST, which was rated on a four-point ranking. Results: In this research, the total occurrence of POST was 30 %. Out of this, POST occurred only in 20 % of study subjects in the (K) category, 23 % of study subjects in the (B) category, contrasted to 47% in the (L) (control) category. The occurrence of POST at 0 hr, 2 hrs, 6 hrs, 12 hrs, 24 hours was 10 %, 10 %, 17 %, 10 % & 7 % respectively in the ketamine-nebulisation category. Conclusion: This research culminates that pre-surgical nebulization with ketamine & betamethasone-gel applied over the cuff of the endo-tracheal -tube is equally successful in reducing POST. Key Word: ketamine-nebulization, betamethasone-gel, lignocaine, Endo-tracheal -intubation

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

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.

Endotracheal Cuff Undersize Diagnosed by Magnetic Resonance Imaging: Case Report

We report a case that the airway can be completely sealed, when the endotracheal tube cuff pressure is 100 cmH2O. The diagnosis was made by the patient’s chest CT（X-ray computed tomography）, This case illustrates that the real cross-sectional area of airway from the case obviously exceeds the normal population.