From the Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey.
Ann Saudi Med. 2024 Sep-Oct;44(5):289-295. doi: 10.5144/0256-4947.2024.289. Epub 2024 Oct 3.
The endotracheal tube (ETT) contains a cuff that is placed in the trachea to prevent gas leakage and aspiration of secretions and gastric contents. However, patient positioning after intubation may cause ETT displacement and changes in cuff pressure.
Evaluate the effect of different patient positions on ETT cuff pressure in patients undergoing urological procedures in supine, prone, lateral flank, and lithotomy positions.
Prospective and observational study.
A university hospital in Turkey.
Patients who underwent surgeries under general anesthesia in different patient positions were involved. After intubation (T0), the cuff pressure was checked with a manometer and adjusted to 25 cmHO and continuously monitored. The cuff pressure was checked before (T1) and after achieving the final position (T2) and then at 5, (T3), 10, (T4), 15 minutes (T5) of the position, at the end of the procedure (T6) and before extubation (T7). At postoperative 2nd and 12th hours, the patients were interviewed for sore throat, hoarseness, and cough.
The effect of different patient positions on the ETT cuff pressure.
SAMPLE SİZE: 200 patients.
The cuff pressure increased significantly at T2 in the lithotomy, lateral flank, and prone groups (<.001 each). The highest increase in cuff pressure occurred in the prone group (34.3 [7.5] cmHO). Over time, the cuff pressure decreased in all groups during surgery. Postoperative complications at the 2nd postoperative hour were similar in all groups; however, the mean cuff pressure was significantly higher in the patients with postoperative sore throat or cough (sore throat: =.003; cough: =.047).
ETT cuff pressures are affected by different patient positioning; therefore, regular recording and adjustment of cuff pressure are necessary for patient safety.
We used ETT of a single manufacturer. Therefore, our findings may not be applicable to other types of ETT.
气管内导管（ETT）包含一个套囊，放置在气管内以防止气体泄漏、分泌物和胃内容物吸入。然而，插管后患者的体位可能导致 ETT 移位和套囊压力改变。
评估不同体位对接受泌尿科手术的患者的 ETT 套囊压力的影响，这些患者采用仰卧位、俯卧位、侧卧位和截石位。
前瞻性和观察性研究。
土耳其的一家大学医院。
纳入在不同体位下接受全身麻醉手术的患者。插管后（T0），使用压力计检查套囊压力，并将其调整至 25cmHO 并持续监测。在调整套囊压力前（T1）、达到最终体位后（T2）以及体位后 5 分钟（T3）、10 分钟（T4）、15 分钟（T5）、手术结束时（T6）和拔管前（T7）检查套囊压力。在术后第 2 小时和第 12 小时，对患者进行咽痛、声音嘶哑和咳嗽的访谈。
不同体位对 ETT 套囊压力的影响。
200 例患者。
在截石位、侧卧位和俯卧位组中，T2 时套囊压力显著升高（<.001 各）。在俯卧位组中，套囊压力的升高幅度最大（34.3[7.5]cmHO）。随着时间的推移，在手术过程中所有组的套囊压力均降低。在术后第 2 小时，所有组的术后并发症相似；然而，有咽痛或咳嗽的患者的平均套囊压力显著较高（咽痛：=.003；咳嗽：=.047）。
ETT 套囊压力受不同患者体位的影响；因此，为了患者安全，需要定期记录和调整套囊压力。
我们使用了单一制造商的 ETT。因此，我们的研究结果可能不适用于其他类型的 ETT。
