Ünsal Özlem, Seyhun Nurullah, Türk Bilge, Ekici Merve, Dobrucalı Hale, Turgut Suat
Department of Otolaryngological, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.
Department of Anesthesia and Reanimation, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2018 Dec 28;52(4):289-295. doi: 10.5350/SEMB.20171214085933. eCollection 2018.
General anesthesia is preferred in most otorhinolaryngologic surgeries. The aim of the present study was to evaluate upper airway complications secondary to intubation including sore throat, cough, dysphonia, and dysphagia considering endotracheal tube (ET) cuff pressure, tube diameter, and duration of intubation.
After the assignment of 67 patients to the study and control groups, ET cuff pressure was adjusted to be between 20 and 30 cm HO using a cuff pressure manometer in the study group. In the control group, the cuff pressure was decided by the anesthesiologist using the conventional palpation method. Sore throat, cough, dysphonia, and dysphagia were compared between the groups at 4, 8, and 24 h postoperatively.
Cuff pressure was significantly higher in the control group than in the study group. In the control group, sore throat was more frequently observed at 4, 8, and 24 h, whereas in the study group, cough and dysphonia were more often observed at 4 and 8 h. At 4 and 8 h, cough was found to be related to the duration of intubation.
Arrangement of cuff pressure using a cuff manometer is suggested to decrease complications of the upper airway secondary to intubation because of the higher rate of these complaints in patients whose cuff pressure is arranged by the conventional palpation method.
大多数耳鼻咽喉科手术首选全身麻醉。本研究的目的是考虑气管内导管（ET）套囊压力、导管直径和插管持续时间，评估插管继发的上呼吸道并发症，包括咽痛、咳嗽、声音嘶哑和吞咽困难。
将67例患者分为研究组和对照组后，研究组使用套囊压力计将ET套囊压力调整为20至30 cm H₂O。对照组中，套囊压力由麻醉医生采用传统触诊法确定。比较两组术后4、8和24小时的咽痛、咳嗽、声音嘶哑和吞咽困难情况。
对照组的套囊压力显著高于研究组。对照组在术后4、8和24小时更常观察到咽痛，而研究组在术后4和8小时更常观察到咳嗽和声音嘶哑。在术后4和8小时，发现咳嗽与插管持续时间有关。
建议使用套囊压力计来设置套囊压力，以减少插管继发上呼吸道并发症，因为采用传统触诊法设置套囊压力时，患者出现这些症状的发生率更高。
