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      Endotracheal cuff pressure change during gynecologic laparoscopic surgery: effect on the incidence of postoperative airway complications

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      https://www.riss.kr/link?id=A104351863

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      다국어 초록 (Multilingual Abstract)

      Background: Laparoscopic surgery with reverse Trendelenburg position and carbon dioxide pneumoperitoneum has been known to increase the endotracheal tube (ETT) cuff pressure and the incidence of postoperative sore throat. The purpose of this study was...

      Background: Laparoscopic surgery with reverse Trendelenburg position and carbon dioxide pneumoperitoneum has been known to increase the endotracheal tube (ETT) cuff pressure and the incidence of postoperative sore throat. The purpose of this study was to evaluate the effect of the Trendelenburg position and pneumoperitoneum on the ETT cuff pressure and the effect of adjustment of ETT cuff pressure on the incidence of sore throat during laparoscopic gynecologic surgery.
      Methods: One hundred fifty-four female patients undergoing laparoscopic gynecologic surgery were randomly assigned to either control group or adjusted group. In control group, initial cuff pressure was set at 30 cmH2O in the supine position without any adjustment during surgery. Cuff pressure of adjusted group was adjusted to maintain 30 cmH2O throughout the operation. Cuff pressures at intubation (Pimme), at carbon dioxide insufflation and the Trendelenburg position (P0), and at 10 minute intervals throughout surgery (P10−P60 and Pend) were checked. Postoperative airway complications including sore throat, hoarseness, dysphagia and cough were compared between the two groups at 2 hours and 24 hours after surgery.
      Results: In control group, P0 and P10 were significantly higher than Pimme. The cuff pressure decreased with time, thereby; P50 (28.2± 4.3), P60 (27.5 ± 4.0) and Pend (25.9 ± 4.2) were significantly lower than Pimme (P < 0.05). The incidences and severity of airway complications were not different between two groups.
      Conclusions: ETT cuff pressure decreased in laparoscopic gynecologic surgery. Therefore, controlled cuff pressure does not decrease the incidence of postoperative airway complications.

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      참고문헌 (Reference)

      1 최연희, "복강경하 자궁적출술 시 기관내튜브 기낭팽창법 중 공기풍선촉진법과 최소기낭용적팽창법이 수술 후 인후통에 미치는 효과 비교" 대한마취통증의학회 6 (6): 380-384, 2011

      2 전영태, "머리와 목의 자세 변화는 기관내튜브 기낭 압력을 변화시킨다" 대한마취통증의학회 50 (50): 54-59, 2006

      3 McHardy F, "Postoperative sore throat: cause, prevention and treatment" 54 : 444-453, 1999

      4 Tu HN, "Nitrous oxide increases endotracheal cuff pressure and the incidence of tracheal lesions in anesthetized patients" 89 : 187-190, 1999

      5 Park SH, "Intraocular pressure changes during gynecologic laparoscopy in patients anesthetized with propofol versus desflurane" 1 : 106-110, 2006

      6 Combes X, "Intracuff pressure and tracheal morbidity: influence of filling cuff with saline during nitrous oxide anesthesia" 95 : 1120-1124, 2001

      7 Rauh R, "Influence of pneumoperitoneum and patient positioning on respiratory system compliance" 13 : 361-365, 2001

      8 Hirvonen EA, "Hemodynamic changes due to Trendelenburg positioning and pneumoperitoneum during laparoscopic hysterectomy" 39 : 949-955, 1995

      9 Dullenkopf A, "Fluid leakage past tracheal tube cuffs: evaluation of the new Microcuff endotracheal tube" 29 : 1849-1853, 2003

      10 Sole ML, "Evaluation of an intervention to maintain endotracheal tube cuff pressure within therapeutic range" 20 : 109-118, 2011

      1 최연희, "복강경하 자궁적출술 시 기관내튜브 기낭팽창법 중 공기풍선촉진법과 최소기낭용적팽창법이 수술 후 인후통에 미치는 효과 비교" 대한마취통증의학회 6 (6): 380-384, 2011

      2 전영태, "머리와 목의 자세 변화는 기관내튜브 기낭 압력을 변화시킨다" 대한마취통증의학회 50 (50): 54-59, 2006

      3 McHardy F, "Postoperative sore throat: cause, prevention and treatment" 54 : 444-453, 1999

      4 Tu HN, "Nitrous oxide increases endotracheal cuff pressure and the incidence of tracheal lesions in anesthetized patients" 89 : 187-190, 1999

      5 Park SH, "Intraocular pressure changes during gynecologic laparoscopy in patients anesthetized with propofol versus desflurane" 1 : 106-110, 2006

      6 Combes X, "Intracuff pressure and tracheal morbidity: influence of filling cuff with saline during nitrous oxide anesthesia" 95 : 1120-1124, 2001

      7 Rauh R, "Influence of pneumoperitoneum and patient positioning on respiratory system compliance" 13 : 361-365, 2001

      8 Hirvonen EA, "Hemodynamic changes due to Trendelenburg positioning and pneumoperitoneum during laparoscopic hysterectomy" 39 : 949-955, 1995

      9 Dullenkopf A, "Fluid leakage past tracheal tube cuffs: evaluation of the new Microcuff endotracheal tube" 29 : 1849-1853, 2003

      10 Sole ML, "Evaluation of an intervention to maintain endotracheal tube cuff pressure within therapeutic range" 20 : 109-118, 2011

      11 Seegobin RD, "Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs" 288 : 965-968, 1984

      12 Ratnaraj J, "Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery" 97 (97): 176-179, 2002

      13 Hong SJ, "Effectiveness of the Streamlined Liner of the Pharynx Airway (SLIPATM) in allowing positive pressure ventilation during gynaecological laparoscopic surgery" 39 : 618-622, 2011

      14 Liu J, "Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: a multicenter study" 111 : 1133-1137, 2010

      15 Yildirim ZB, "Changes in cuff pressure of endotracheal tube during laparoscopic and open abdominal surgery" 26 : 398-401, 2012

      16 Casati A, "Cardiorespiratory changes during gynaecological laparoscopy by abdominal wall elevation: comparison with carbon dioxide pneumoperitoneum" 78 : 51-54, 1997

      17 Sole ML, "Assessment of endotracheal cuff pressure by continuous monitoring: a pilot study" 18 : 133-143, 2009

      18 Gerges FJ, "Anesthesia for laparoscopy: a review" 18 : 67-78, 2006

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