The effect of endotracheal tube cuff pressure control on postextubation throat pain in orthognathic surgeries: a randomized double-blind controlled clinical trial

Br J Oral Maxillofac Surg. 2014 Feb;52(2):140-3. doi: 10.1016/j.bjoms.2013.10.005. Epub 2013 Nov 21.

Abstract

Pain in the throat after extubation is one of the most common complaints after maxillofacial operations under general anaesthesia. We have evaluated the amount of pain after extubation when we controlled the pressure in the endotracheal cuff during operation by analysing the records of 43 patients who had maxillofacial operations under general anaesthesia. In the study group (n=20) the cuff pressure of the endotracheal tube was adjusted using a pressure gauge at the beginning of intubation and every hour during operation. In the control group (n=23), an experienced anaesthetist adjusted the pressure only at the beginning of the operation by palpating the pilot balloon. Throat pain was evaluated 1, 6, and 24h postoperatively on a visual analogue scale (VAS), and the pain scores in the control and study groups postoperatively was 5.3 (1.1) compared with 3.9 (1.5) (p=0.002); 4.5 (1.3) compared with 3.1 (1.5) (p=0.002); and 1.9 (1.1) compared with 1.6 (1.2) (p=0.4), respectively. The differences between the two groups at 1h and 6h postoperatively were significant, but that at 24h was not. Control of the cuff pressure of the endotracheal tube with a gauge at the beginning of the operation, and adjustment of the pressure during operation, can reduce postoperative complications such as throat pain.

Keywords: Anesthesiology; Endotracheal cuff pressure; Endotracheal intubation; Oral surgery; Orthognathic surgery; Randomized controlled clinical trial.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Airway Extubation / adverse effects*
  • Anesthesia, General / methods
  • Anesthetics, Intravenous / administration & dosage
  • Double-Blind Method
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Intubation, Intratracheal / instrumentation*
  • Male
  • Operative Time
  • Orthognathic Surgical Procedures / instrumentation*
  • Pain Measurement / methods
  • Pain, Postoperative / etiology*
  • Pharyngeal Diseases / etiology*
  • Piperidines / administration & dosage
  • Pressure
  • Propofol / administration & dosage
  • Prospective Studies
  • Remifentanil
  • Visual Analog Scale

Substances

  • Anesthetics, Intravenous
  • Piperidines
  • Remifentanil
  • Propofol