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体位改变对全身麻醉患者气管导管套囊压力及术后咽痛和声音嘶哑的影响

The Effect of Position Changing on Endotracheal Tube Cuff Pressure and Post-Operation Sore Throat and Hoarseness in Patients Undergoing General Anesthesia.

作者信息

Tabari Masoomeh, Rajabi Faezeh, Moradi Ali, Sharifian Attar Alireza

机构信息

Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Otorhinolaryngol. 2025;37(4):213-219. doi: 10.22038/ijorl.2025.85571.3870.

Abstract

INTRODUCTION

Endotracheal intubation is a standard procedure for securing and maintaining the airway during general anesthesia. Cuff pressure must be within the correct range to avoid serious airway complications. This study aimed to assess how the pressure in the endotracheal tube cuff changes when the patient's position is altered.

MATERIALS AND METHODS

This prospective, observational study was conducted on 85 patients aged 18 to 75 undergoing general anesthesia for surgery. Endotracheal intubation was performed with an appropriately sized tube, and the tube cuff was inflated with air using a syringe. The cuff pressure of the endotracheal tube was then assessed using a cuff manometer immediately after intubation and position change, 5 minutes after each, and every 15 minutes until the end of the surgery. Based on the formula for testing the difference between two means for a quantitative trait in two populations, and considering an alpha of 0.05 and a beta of 0.2, the sample size was calculated as 20 individuals in each group of patients with different positions.

RESULTS

The endotracheal cuff pressure increased in all three positions, including prone, right lateral, and left lateral. A significant relationship was also observed between the sore throat one hour after extubation and the prone position.

CONCLUSION

The ETT cuff pressure increased or decreased outside the normal range in most patients undergoing surgeries that require changing positions. Therefore, we recommend close and continuous monitoring of cuff pressure during anesthesia.

摘要

引言

气管插管是全身麻醉期间确保和维持气道通畅的标准操作。套囊压力必须在正确范围内,以避免严重的气道并发症。本研究旨在评估患者体位改变时气管导管套囊内压力如何变化。

材料与方法

本前瞻性观察性研究对85例年龄在18至75岁接受手术全身麻醉的患者进行。使用尺寸合适的导管进行气管插管,并用注射器向导管套囊内充气。在插管后和体位改变后立即、每次改变后5分钟以及每隔15分钟直至手术结束,使用套囊压力计评估气管导管的套囊压力。根据用于检验两个总体定量性状均值差异的公式,并考虑α为0.05和β为0.2,计算出不同体位患者每组样本量为20例。

结果

在俯卧位、右侧卧位和左侧卧位这三种体位下,气管套囊压力均升高。拔管后1小时出现的咽痛与俯卧位之间也存在显著关联。

结论

在大多数需要改变体位的手术患者中,气管导管套囊压力升高或降低至正常范围之外。因此,我们建议在麻醉期间密切且持续地监测套囊压力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50a4/12335663/442ba4155ce3/ijo-37-213-g001.jpg

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