Monitoring tracheal tube cuff pressure reduces postoperative sore throat symptoms

Kovacevic, Mary P; Pavičić, Ana Marija; Markić, Ana; Rancic, Zuric I.; Tonković, Dinko

doi:10.1097/00003643-201306001-00167

Cited by 5 publications

(5 citation statements)

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“…From 1009 papers identified, 985 were eliminated on abstract review due to duplicate copies or meeting the a priori exclusion criteria ( Figure 1). The 24 remaining studies were full-text reviewed and excluded if they were nonrandomised controlled trials 25,26,[34][35][36][37] , not available in English 38 , full text not available 39,40 or not on the actual topic 23,[41][42][43][44] . This systematic review was based upon nine studies including seven RCTs [45][46][47][48][49][50][51] and two pseudo-randomised controlled trials where interventions were compared but participants were not randomly allocated to groups 52,53 .…”

Section: Resultsmentioning

confidence: 99%

Does Objective Measurement of Tracheal Tube Cuff Pressures Minimise Adverse Effects and Maintain Accurate Cuff Pressures? A Systematic Review and Meta-Analysis

Hockey

Zundert

Paratz

2016

Anaesth Intensive Care

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Correct inflation pressures of the tracheal cuff are recommended to ensure adequate ventilation and prevent aspiration and adverse events. However there are conflicting views on which measurement to employ. The aim of this review was to examine whether adjustment of cuff pressure guided by objective measurement, compared with subjective measurement or observation of the pressure value alone, was able to prevent patient-related adverse effects and maintain accurate cuff pressures. A search of PubMed, Web of Science, Embase, CINAHL and ScienceDirect was conducted using keywords 'cuff pressure' and 'measure*' and related synonyms. Included studies were randomised or pseudo-randomised controlled trials investigating mechanically ventilated patients both in the intensive care unit and during surgery. Outcomes included adverse effects and the comparison of pressure measurements. Pooled analyses were performed to calculate risk ratios, effect sizes and 95% confidence intervals. Meta-analysis found preliminary evidence that adjustment of cuff pressure guided by objective measurement as compared with subjective measurement or observation of the pressure value alone, has benefit in preventing adverse effects. These included cough at two hours (odds ratio [OR] 0.42, confidence interval [CI] 0.23 to 0.79, P=0.007), hoarseness at 24 hours (OR 0.49, CI 0.31 to 0.76, P <0.002), sore throat (OR 0.73, CI 0.54 to 0.97, P <0.03), lesions of the trachea and incidences of silent aspiration (P=0.001), as well as maintaining accurate cuff pressures (Hedges' g 1.61, CI 2.69 to 0.53, P=0.003). Subjective measurement to guide adjustment or observation of the pressure value alone may lead to patient-related adverse effects and inaccuracies. It is recommended that an objective form of measurement be used.

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Section: Resultsmentioning

confidence: 99%

Does Objective Measurement of Tracheal Tube Cuff Pressures Minimise Adverse Effects and Maintain Accurate Cuff Pressures? A Systematic Review and Meta-Analysis

Hockey

Zundert

Paratz

2016

Anaesth Intensive Care

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“…15 Many other studies support monitoring P INTRACUFF intraoperatively to reduce the incidence of a postoperative sore throat. 8,[16][17][18][19][20][21][22][23] Although cuff manometers can be used to guide the monitoring of cuff pressures, their use and availability is not mandatory in many institutions around the world. A meta-analysis of nine studies by Hockey et al demonstrated that adjustment of P INTRACUFF guided by objective measurement as compared with subjective measurement or observation of the pressure value alone, has benefits in preventing adverse effects including voice hoarseness, cough, tissue damage, and aspiration.…”

Section: Introductionmentioning

confidence: 99%

Bi-national survey of intraoperative cuff pressure monitoring of endotracheal tubes and supraglottic airway devices in operating theatres

Lee

Reynolds

Pelecanos

et al. 2019

Anaesth Intensive Care

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Correct intracuff pressure of endotracheal tubes and supraglottic airway devices is required to avoid complications such as sore throat, dysphagia and dysphonia, while maintaining an adequate airway seal. However, intracuff pressure monitoring of airway devices during general anaesthesia may not receive the attention it deserves. The aim of this survey was to investigate the current practice regarding intraoperative cuff pressure monitoring in hospitals across Australia and New Zealand. An online ten-question survey was disseminated by the Australian and New Zealand College of Anaesthetists Clinical Trials Network to a randomised selection of 1000 Australian and New Zealand College of Anaesthetists Fellows working in private and public hospitals of varying sizes. There were 305 respondents in total, but not all respondents answered all questions. In total, 67 of 304 respondents (22.0%) did not have access to a cuff pressure manometer at their main site of work, and of these, 30 (9.9%) expressed that they would like access to one in their daily practice. Of 288 respondents, 122 (40.0%) reported that they used cuff pressure monitoring as part of their routine practice, but 95 (33.0%) measured the cuff pressure at induction only. For supraglottic airway devices, only 44 of 250 respondents (17.6%) aimed for a cuff pressure of 40–60 cmH2O. Of 255 respondents, 101 (39.6%) aimed for a cuff pressure of 20–30 cmH2O for endotracheal tubes. These findings indicate that educational programmes are required to increase the availability and use of cuff pressure monitoring devices for both endotracheal tubes and supraglottic airway devices across Australia and New Zealand.

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“…Sin embargo, es importante destacar que estos resultados se basan en un núme-ro limitado de pacientes, lo que puede influir en la falta de significancia estadística. Además, y en concordancia con otros estudios 8,20,21 , se observó una asociación proporcional entre la valoración del dolor y la presión del manguito en el grupo de pacientes que experimen-tó dolor, como lo indica el coeficiente de correlación de Spearman (r=0.3). Esto sugiere que a medida que la presión del manguito aumenta, los pacientes informaron niveles de dolor más elevados.…”

Section: Discussionunclassified

Presiones del balón de neumotaponamiento del tubo endotraqueal asociado con dolor orofaríngeo en el posoperatorio en pacientes adultos que requirieron una colecistectomía laparoscópica en el Hospital Británico.

Fernández Gianni,

Ernst,

Romero

2023

RFEM

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Introducción. Antecedentes de la literatura han reportado que el dolor orofaríngeo estaría relacionado con la presión del balón. El estudio tuvo como objetivo investigar la asociación entre la presión del manguito del tubo endotraqueal y el dolor en pacientes quirúrgicos sometidos a colecistectomías laparoscópicas electivas. Materiales y métodos. Los datos utilizados, fueron recolectados de los registros del Servicio de Anestesiología del Hospital. Se incluyeron un total de 33 pacientes sometidos a procedimientos quirúrgicos. Los pacientes se dividieron en grupos con dolor y sin dolor en función de la presencia o ausencia de dolor. Ambos grupos mostraron características basales similares. Resultados. No se observaron diferencias estadísticamente significativas en la presión del manguito del tubo endotraqueal entre los grupos con y sin dolor. En el grupo de dolor, se observó una asociación proporcional entre la evaluación del dolor orofaríngeo y la presión del manguito. Una mayor presión del manguito se asoció con mayores niveles de dolor (r=0.3; p<0.05). Discusión. Este estudio, sugiere una asociación potencial entre la presión del manguito del tubo endotraqueal y el dolor en pacientes quirúrgicos. Sin embargo, se necesitan más investigaciones con un tamaño de muestra mayor y una metodología rigurosa para establecer conclusiones definitivas. El estudio subraya la importancia de los enfoques individualizados del tratamiento del dolor, la consideración de otras variables y la adopción de una estrategia multimodal para el control eficaz del dolor perioperatorio.Palabras clave: presión del manguito del tubo endotraqueal, dolor.

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Monitoring tracheal tube cuff pressure reduces postoperative sore throat symptoms

Cited by 5 publications

References 0 publications

Does Objective Measurement of Tracheal Tube Cuff Pressures Minimise Adverse Effects and Maintain Accurate Cuff Pressures? A Systematic Review and Meta-Analysis

Does Objective Measurement of Tracheal Tube Cuff Pressures Minimise Adverse Effects and Maintain Accurate Cuff Pressures? A Systematic Review and Meta-Analysis

Bi-national survey of intraoperative cuff pressure monitoring of endotracheal tubes and supraglottic airway devices in operating theatres

Presiones del balón de neumotaponamiento del tubo endotraqueal asociado con dolor orofaríngeo en el posoperatorio en pacientes adultos que requirieron una colecistectomía laparoscópica en el Hospital Británico.

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