Saraçoğlu Ayten, Dal Didem, Pehlivan Gökhan, Göğüş Fevzi Yılmaz
Department of Anaesthesiology, Marmara University Faculty of Medicine, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2014 Oct;42(5):234-8. doi: 10.5152/TJAR.2014.87487. Epub 2014 Jul 9.
Cuffs inflated to inappropriately high pressures cause ischemia, reducing tracheal mucosal blood flow, while cuffs inflated at lower pressure than necessary give rise to inadequate ventilation, aspiration of gastric contents, or extubation due to air leakage. In this study, we aimed to investigate the effect of the experience of anaesthesia staff on endotracheal tube and laryngeal mask airway cuff inflation.
The study included 348 elective patients scheduled to undergo surgery under general anaesthesia, with 34 anaesthesia technicians, 16 anaesthesia residents, and 12 anaesthesiologists with different years of professional experience. The participants were told to inflate the cuff balloon with air to the level of the pressure that was appropriate for them. No information was provided to the participants about the values of the cuff pressure pending the completion of all measurements. After placement of the laryngeal mask airway and endotracheal tube, the success of the procedure was checked by monitoring square-wave capnograph tracing and thoracoabdominal motion. Each participant performed the procedures on three patients, and the mean cuff pressures were measured.
There was no significant correlation between duration of experience of technicians, residents, and experts in using laryngeal mask airway pressure (r=-0.192/p=0.278, r=0.225/p=0.402, r=-0.476/p=0.118, respectively) and endotracheal tube (r=-0.306/p=0.079, r=-0.060/p=0.826, r=-0.478/0.116, respectively).
It has been concluded that professional experience does not contribute to achieving normal cuff pressure without monitoring. Introduction of the cuff manometer into routine anaesthesia practice will be useful, irrespective of anaesthesiologists' experience.
气管导管套囊充气压力过高会导致局部缺血，减少气管黏膜血流，而套囊充气压力低于所需水平则会导致通气不足、胃内容物误吸或因漏气导致气管导管拔除。在本研究中，我们旨在调查麻醉工作人员的经验对气管导管和喉罩气道套囊充气的影响。
本研究纳入了348例计划在全身麻醉下接受手术的择期患者，以及34名麻醉技术员、16名麻醉住院医师和12名具有不同专业经验年限的麻醉医师。告知参与者用空气将套囊气球充气至适合他们的压力水平。在完成所有测量之前，未向参与者提供有关套囊压力值的信息。放置喉罩气道和气管导管后，通过监测方波二氧化碳波形图和胸腹运动来检查操作是否成功。每位参与者对三名患者进行操作，并测量套囊平均压力。
技术员、住院医师和专家使用喉罩气道压力的经验时长（分别为r=-0.192/p=0.278，r=0.225/p=0.402，r=-0.476/p=0.118）与气管导管（分别为r=-0.306/p=0.079，r=-0.060/p=0.826，r=-0.478/0.116）之间均无显著相关性。
得出的结论是，在没有监测的情况下，专业经验无助于实现正常的套囊压力。无论麻醉医师的经验如何，将套囊压力计引入常规麻醉实践都将是有用的。
