Kim Deokkyu, Jeon Byeongdo, Son Ji-Seon, Lee Jun-Rae, Ko Seonghoon, Lim Hyungsun
Department of Anesethesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Korea.
Department of Oral and Maxillofacial Surgery, Chonbuk National University Dentistry School, Jeonju, Korea.
Korean J Anesthesiol. 2015 Feb;68(1):27-31. doi: 10.4097/kjae.2015.68.1.27. Epub 2015 Jan 28.
The proper cuff pressure is important to prevent complications related to the endotracheal tube (ETT). We evaluated the change in ETT cuff pressure by changing the position from supine to prone without head movement.
Fifty-five patients were enrolled and scheduled for lumbar spine surgery. Neutral angle, which was the angle on the mandibular angle between the neck midline and mandibular inferior border, was measured. The initial neutral pressure of the ETT cuff was measured, and the cuff pressure was subsequently adjusted to 26 cmH2O. Flexed or extended angles and cuff pressure were measured in both supine and prone positions, when the patient's head was flexed or extended. Initial neutral pressure in prone was compared with adjusted neutral pressure (26 cmH2O) in supine. Flexed and extended pressure were compared with adjusted neutral pressure in supine or prone, respectively.
There were no differences between supine and prone position for neutral, flexed, and extended angles. The initial neutral pressure increased after changing position from supine to prone (26.0 vs. 31.5 ± 5.9 cmH2O, P < 0.001). Flexed and extended pressure in supine were increased to 38.7 ± 6.7 (P < 0.001) and 26.7 ± 4.7 cmH2O (not statistically significant) than the adjusted neutral pressure. Flexed and extended pressure in prone were increased to 40.5 ± 8.8 (P < 0.001) and 29.9 ± 8.7 cmH2O (P = 0.002) than the adjusted neutral pressure.
The position change from supine to prone without head movement can cause a change in ETT cuff pressure.
合适的气管导管套囊压力对于预防与气管内插管（ETT）相关的并发症很重要。我们评估了在头部无移动的情况下，从仰卧位变为俯卧位时ETT套囊压力的变化。
纳入55例计划行腰椎手术的患者。测量中立角，即颈部中线与下颌下缘之间下颌角的角度。测量ETT套囊的初始中立压力，随后将套囊压力调整至26 cmH₂O。当患者头部屈曲或伸展时，在仰卧位和俯卧位测量屈曲或伸展角度及套囊压力。将俯卧位的初始中立压力与仰卧位调整后的中立压力（26 cmH₂O）进行比较。将屈曲和伸展压力分别与仰卧位或俯卧位调整后的中立压力进行比较。
仰卧位和俯卧位在中立、屈曲和伸展角度方面无差异。从仰卧位变为俯卧位后，初始中立压力增加（26.0 vs. 31.5±5.9 cmH₂O，P<0.001）。仰卧位的屈曲和伸展压力比调整后的中立压力分别增加至38.7±6.7（P<0.001）和26.7±4.7 cmH₂O（无统计学意义）。俯卧位的屈曲和伸展压力比调整后的中立压力分别增加至40.5±8.8（P<0.001）和29.9±8.7 cmH₂O（P = 0.002）。
在头部无移动的情况下，从仰卧位变为俯卧位会导致ETT套囊压力发生变化。
