期刊论文详细信息
Frontiers in Medicine
A Tapered Cuff Tracheal Tube Decreases the Need for Cuff Pressure Adjustment After Surgical Retraction During Anterior Cervical Spine Surgery: A Randomized Controlled, Double-Blind Trial
article
Wen-Kuei Chang1  Ya-Chun Chu1  Yi-Shiuan Li1  Elise Chia-Hui Tan3  Yueh-Ju Tsai5  Mercedes Susan Mandell6  Shiang-Suo Huang8  Ting-Yun Chiang1  Wen-Cheng Huang2 
[1] Department of Anesthesiology, Taipei Veterans General Hospital;School of Medicine, National Yang Ming Chiao Tung University, Hsinchu;National Research Institute of Chinese Medicine, Ministry of Health and Welfare;Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Hsinchu;Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital;Department of Anesthesiology, University of Colorado;Department of Anesthesiology, McGovern Medical School, Memorial Hermann-Texas Medical Center, University of Texas Health;Department of Pharmacology, Institute of Medicine, Chung Shan Medical University;Department of Pharmacy, Chung Shan Medical University Hospital;Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital
关键词: anterior cervical spine surgery;    dysphonia;    GRBAS;    tapered cuff;    tracheal tube cuff pressure;   
DOI  :  10.3389/fmed.2022.920726
学科分类:社会科学、人文和艺术(综合)
来源: Frontiers
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【 摘 要 】

Background Surgical retraction to expose the vertebrae during anterior cervical spine surgery increases tracheal tube cuff pressure and may worsen postoperative sore throat and dysphonia. This randomized double-blind study investigated the effect of cuff shape on intraoperative cuff pressure and postoperative sore throat and dysphonia. Methods Eighty patients were randomized to tracheal intubation with a tapered cuff or a conventional cylindrical high-volume low-pressure cuff (control) during anesthesia. Intraoperative cuff pressures were compared. The primary outcome was the incidence of pressure adjustment needed when the cuff pressure increased to > 25 mm Hg after surgical retraction. The secondary outcome was the incidence of postoperative sore throat and dysphonia. Results The incidence of pressure adjustment after surgical retraction was significantly lower in the tapered group than in the control group (13% vs. 48%; P = 0.001; relative risk reduction, 74%). The median [interquartile range (IQR)] cuff pressure (mm Hg) was significantly lower for the tapered cuff than for the control cuff before surgical retraction [9 (7–12) vs. 12 (10–15); P < 0.001] and after retraction [18 (15–23) vs. 25 (18–31); P = 0.007]. The median (IQR) postoperative dysphonia score assessed by a single speech-language pathologist was lower in the tapered group than in the control group [4 (3–6) vs. 5.5 (5–7); P = 0.008]. Conclusion A tapered cuff tracheal tube decreased the need for the adjustment of cuff pressure after surgical retraction during anterior cervical spine surgery, thereby avoiding intraoperative pressure increase. It also has a better outcome in terms of dysphonia.

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