Maintaining optimal endotracheal tube cuff pressure with pressure gauge reduces the frequency of postoperative airway complications during endoscopic cervical spine surgery

Abstract

Background: Endotracheal cuff, when inflated to extremely high pressures lead to tracheal ischemia due to reduced tracheal blood supply while faulty ventilation and aspiration of gastric content or accidental extubation can occur when underinflated. In this study we evaluate the effects of maintaining fixed optimal cuff pressure (25 cmH₂O) during endoscopic anterior cervical spine surgeries, in terms of postoperative airway complications.
Methodology: In our study 100 cases were scheduled to undergo elective anterior cervical spine surgeries under general anesthesia (GA). These cases were divided into two groups according to cuff inflation technique. In Group P (study group), endotracheal tube cuff (ETTc) was inflated with air syringe by senior anesthesiologist. Cuff pressure was estimated by feel of pilot balloon and by absence of audible air leak. Later endotracheal tube cuff pressure (PETTc) was recorded and monitored every 30 min by Portex™ Cuff Inflator pressure gauge. In Group C (control group), ETTc was inflated by attaching with Portex™ Cuff Inflator pressure gauge and pressure was sustained at 25 cmH₂O till patient remains intubated. Both groups were observed for development of any airway complications at 24 hours post-extubation.