The Effect of the Endotracheal Cuff and Alveolar Pressures on Laryngopharyngeal Outcomes in Laparoscopic and Open Gynecological Procedure

Abstract

Objective:High intra-abdominal pressure during laparoscopic surgery (LS) may increase endotracheal tube cuff pressure in patients. This study aimed to evaluate the effect of endotracheal tube cuff pressure and alveolar pressures on laryngopharyngeal outcomes at different time points during laparoscopic and open surgeries.Method:Seventy patients who underwent open or LS were included in our study. The cuff pressure, peak inspiratory pressure (PIP), and plateau pressure values were measured after endotracheal intubation, at 15th, 30th, and 60th minutes after intra-abdominal carbon dioxide (CO2) insufflation and before extubation. In addition, all patients were evaluated for sore throat using the visual analogue scale (VAS) at 1st, 12th, and 24th hours postoperatively by an observer blinded to the study groups.Results:The patients in the LS group had statistically significantly higher cuff, PIP, and P-plateau levels at 15th, 30th, and 60th minutes after intubation and before extubation compared to those in the open surgery (OS) group (p <0.05 for all comparisons). At postoperative 12th hour, dysphagia was observed in four (10%) patients, and cough was present in 11 (30%) patients in the LS group. The VAS score for sore throat periods was significantly higher in the LS group than in the OS group at followup hours (p<0.05 for all comparisons). Extended operation time and cuff pressure at different time points were significantly associated with a sore throat (p<0.05 for all correlations).Conclusion:Endotracheal tube cuff pressures and airway pressures should be monitored, especially in LS, to protect the mucosal layer of the trachea.

Keywords

• anesthesia
• endotracheal
• laparoscopic surgery
• pneumoperitoneum
• sore throat