Korean Journal of Adult Nursing (성인간호학회지)

Korean Society of Adult Nursing (한국성인간호학회)
권호 표지

The Effect of Cuff Pressure of Endotrachel Tube on Postoperative Sore Throat

기관내관의 기낭압 조정이 수술 후 인후통에 미치는 영향

  • Na, Hye-Kyoung (Department of Nursing, Incheon Medical Center) ;
  • Yoon, Hae-Sang (Department of Nursing, Gachon University of Medicine & Science)
  • 나혜경 (지방공사 인천의료원 마취전문) ;
  • 윤혜상 (가천의과학대학교 간호학과)
  • Received : 2009.09.08
  • Accepted : 2009.10.16
  • Published : 2009.10.31
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Abstract

Purpose: The purpose of this study was to identify the effects of cuff pressure on postoperative sore throat. Methods: Data were collected from January 4 through May 15, 2008. Among the 60 patients, 30 patients were randomly assigned to the control group and the rest to the experimental group. Initial cuff pressure of both groups was set at 20 $cmH_2O$. The experimental group was maintained at 20 $cmH_2O$ throughout the anesthesia, while the control group was not regulated further. Sore throat was assessed at postoperative 1, 24 and 72 hours. Data were analyzed using Mann-Whitney test and Spearman's rho coefficients. Results: Cuff pressure in control group increased from 20 to 43 $cmH_2O$ within 3 hours after induction. However, the experimental group showed that there was apparently a reduced rate of sore throat at postoperative 24 hours (p = .048), and 72 hours (p = .002) than in the control group. However, no outstanding differences between both groups at postoperative 1 hour (p = .081) were detected. The correlation between cuff pressure and sore throat was statistically significant ($r_s$ = .590, p < .001). Conclusion: We conclude that maintaining cuff pressure at 20 $cmH_2O$ could be an effective means to reduce sore throat in surgical patients with inhalation anesthesia.

Keywords

References

  1. Ahmad, N. L., & Norsidah, A. M. (2001) Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: A comparison between air and distilled water cuff inflation. Anaesthesia and Intensive Care, 29, 510-514.
  2. Bennett, M. H., Isert, P. R., & Cumming, R. G. (2000). Postoperative sore throat and hoarseness following tracheal intubation using air or saline to inflate the cuff-a randomized controlled trial. Anaesthesia and Intensive Care, 28, 408-413.
  3. Biro, P., Seifert, B., & Pasch, T. (2005). Complaints of sore throat after tracheal intubation: A prospective evaluation. European Journal of Anaesthesiology, 22, 307-311. https://doi.org/10.1017/S0265021505000529
  4. Charuluxananan, S., Sumethawattana, P., Kosawiboonpol, R., Somboonviboon, W., & Werawataganon, T. (2004). Effectiveness of lubrication of endotracheal tube cuff with chamomile- extract for prevention of postoperative sore throat and hoarseness. Journal of the Medical Association of Thailand, 87(Suppl 2), S185-189.
  5. Christensen, A. M., Willemoes-Larsen, H., Lundby, L., & Jakobsen, K. B. (1994). Postoperative throat complaints after tracheal intubation. British Journal of Anaesthesia, 73, 786-787. https://doi.org/10.1093/bja/73.6.786
  6. Chung, I. S., Yum, K. W., & Ko, H. (1985). A study of cuff pressure in the endotracheal tube. Korean Journal of Anesthesiology, 18, 381-387. https://doi.org/10.4097/kjae.1985.18.4.381
  7. Combes, X., Schauvliege, F., Peyrouset, O., Motamed, C., Kirov, K., Dhonneur, G., & Duvaldestin, P. (2001). Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology, 95, 1120-1124. https://doi.org/10.1097/00000542-200111000-00015
  8. Dobrin, P., & Canfield, T. (1977). Cuffed endotracheal tubes: Mucosal pressures and tracheal wall blood flow. American Journal of Surgery, 133(5), 562-568. https://doi.org/10.1016/0002-9610(77)90008-3
  9. Higgins, P. P., Chung, F., & Mezei, G. (2002). Postoperative sore throat after ambulatory surgery. British Journal of Anaesthesia, 88, 582-584. https://doi.org/10.1093/bja/88.4.582
  10. Hwang, G. B., Lee, S. I., Park, H. S., & Chung, C. J. (1997). Incidence of sore throat after tracheal intubation and postoperative. Korean Journal of Anesthesiology, 33, 533-539. https://doi.org/10.4097/kjae.1997.33.3.533
  11. Kang, H., Kim, K. J., Baek, C. W., Woo, Y. C., Kim, J. Y., & Park, S. G. (2006). The effect of cuff pressure of laryngeal tube on postoperative sore throat after general anesthesia using $N_2O$. Korean Journal of Anesthesiology, 50, 266-271. https://doi.org/10.4097/kjae.2006.50.3.266
  12. Kloub, R. (2001). Sore throat following tracheal intubation. Middle East Journal of Anesthesiology, 16, 29-40.
  13. Kunitz, O., Jansen, R., Ohnsorge, E., Haaf-vonBelow, S., Schulz- Stübner, S., & Rossaint, R. (2004). Cuff pressure monitoring and regulation in adults. Der Anaesthesist, 53, 334-340 https://doi.org/10.1007/s00101-004-0664-6
  14. Maino, P., Dullenkopf, A., Bernet, V., & Weiss, M. (2005). Nitrous oxide diffusion into the cuffs of disposable laryngeal mask airways. Anaesthesia, 60, 278-282. https://doi.org/10.1111/j.1365-2044.2004.04072.x
  15. Maruyama, K., Sakai, H., Miyazawa, H., Iijima, K., Toda, N., Kawahara, S., & Hara, K. (2004). Laryngotracheal application of lidocaine spray increases the incidence of postoperative sore throat after total intravenous anesthesia. Journal of Anesthesia, 18, 237-240. https://doi.org/10.1007/s00540-004-0264-2
  16. McHardy, F. E., & Chung, F. (1999). Postoperative sore throat: Cause, prevention and treatment. Anaesthesia, 54, 444-453. https://doi.org/10.1046/j.1365-2044.1999.00780.x
  17. Morgan, G. E., Mikhail, M. S., & Murray, M. J. (2006). Clinical Anesthesiology (4th ed.). Seoul: McGraw Hill.
  18. Ogata, J., Minami, K., T., Horishita, T., Shiraishi, M., Okamoto, T., Terada, T., & Sata, T. (2005). Gargling with sodium azulene sulfonate reduces the postoperative sore throat after intubation of the trachea. Anesthesia and Analgesia, 101, 290-293 https://doi.org/10.1213/01.ANE.0000156565.60082.7C
  19. Priebe, H. J. (2000). $N_2O$ and endotracheal cuff pressure. Anesthesia and Analgesia, 90, 230-231. https://doi.org/10.1097/00000539-200001000-00055
  20. Ryoo, H. J. (2008, April). Specific practice of nurse anesthetist. Report presented at the meeting of the Korean Nurse Anesthetists Association, Incheon.
  21. Ryu, T. G., Kim, J. S., Lee, M. K., Park, Y. C., Lim, S. H., Yoon, S. M., & Choi, Y. S. (1997). Postoperative Sore Throat with Foam Cuffed Endotracheal Tube. Korean Journal of Anesthesiology, 32, 533-538. https://doi.org/10.4097/kjae.1997.32.4.533
  22. Seegobin, R. D., & van Hasselt, G. L. (1984). Endotracheal cuff pressure and tracheal mucosal blood flow: Endoscopic study of effects of four large volume cuffs. British Medical Journal, 288, 965-968. https://doi.org/10.1136/bmj.288.6422.965
  23. Somri, M., Fradis, M., Malatskey, S., Vaida, S., & Gaitini, L. (2002). Simple on-line endotracheal cuff pressure relief valve. The Annals of Otology, Rhinology & Laryngology, 111, 190-192. https://doi.org/10.1177/000348940211100215
  24. Stewart, S. L., Secrest, J. A., Norwood, B. R., & Zachary, R. (2003). A comparison of endotracheal tube cuff pressures using estimation techniques and direct intracuff measurement. AANA Journal, 71, 259-267.
  25. Sumathi, P. A., Shenoy, T., Ambareesha, M., & Krishna, H. M. (2008). Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. British Journal of Anaesthesia, 100, 215-218. https://doi.org/10.1093/bja/aem341
  26. Suzuki, N., Kooguchi, K., Mizobe, T., Hirose, M., Takano, Y., & Tanaka, Y. (1999). Postoperative hoarseness and sore throat after tracheal intubation: Effect of a low intracuff pressure of endotracheal tube and the usefulness of cuff pressure indicator. Masui. The Japanese Journal of Anesthesiology, 48, 1091-1095.
  27. Tu, H. N., Saidi, N., Leiutaud, T., Bensaid, S., Menival, V., & Duvaldestin, P. (1999). Nitrous oxide increases endotracheal cuff pressure and the incidence of tracheal lesions in anesthetized patients. Anesthesia and Analgesia, 89, 187-190. https://doi.org/10.1097/00000539-199907000-00033