Sperry R J, Johnson J O, Apfelbaum R I
Department of Anesthesiology, University of Utah, Salt Lake City 84132.
Anesth Analg. 1993 Jun;76(6):1318-21. doi: 10.1213/00000539-199376060-00023.
To determine whether endotracheal tube cuff pressure increases significantly with surgical retraction and cervical spine distraction during anterior cervical spine surgery with Caspar instrumentation, we prospectively studied 10 patients undergoing this procedure. The tracheas of all patients were intubated with a Mallinckrodt Hi-Lo endotracheal tube. Tracheal tube cuff pressures measured with a transducer system were 42.4 mm Hg +/- 7.0 mm Hg (SEM) after intubation and cuff inflation. Air was removed from the endotracheal tube cuff until the trachea was just barely sealed at a cuff pressure of 15.2 mm Hg +/- 1.6 mm Hg. The endotracheal tube cuff pressure was readjusted to "just-seal" pressure before the surgeons introduced the Caspar instrumentation. The cuff pressure with traction and distraction was 43.2 mm Hg +/- 5.0 mm Hg. This pressure was significantly increased from the "just-seal" pressure, and from the cuff pressure after instrumentation was discontinued (9.8 mm Hg +/- 2.3 mm Hg). We conclude that anterior cervical spine surgery with Caspar instrumentation is associated with a significant increase in endotracheal tube cuff pressure.
为了确定在使用卡斯帕器械进行颈椎前路手术期间，气管插管套囊压力是否会随着手术牵拉和颈椎牵引而显著升高，我们对10例接受该手术的患者进行了前瞻性研究。所有患者均使用 Mallinckrodt Hi-Lo 气管插管进行气管插管。插管并充盈套囊后，用换能器系统测得的气管插管套囊压力为42.4毫米汞柱±7.0毫米汞柱（标准误）。从气管插管套囊中抽出空气，直到在套囊压力为15.2毫米汞柱±1.6毫米汞柱时气管刚好密封。在外科医生引入卡斯帕器械之前，将气管插管套囊压力重新调整至“刚好密封”压力。牵引和撑开时的套囊压力为43.2毫米汞柱±5.0毫米汞柱。该压力与“刚好密封”压力相比显著升高，与停止器械操作后的套囊压力（9.8毫米汞柱±2.3毫米汞柱）相比也显著升高。我们得出结论，使用卡斯帕器械进行颈椎前路手术与气管插管套囊压力显著升高有关。
