Effects of continuous and slow tracheal tube cuff deflation on cough reflex during extubation in noncardiac surgery patients: a randomised clinical trial

BMC Anesthesiology

Research

Xuan Wang¹  Manlin Duan²  Jing Tan³  Guangli Zhu⁴  Xinyu Cao⁴ 

[1] Department of Anesthesiology, Benq medical center & Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, No. 71 Hexi Avenue, Jianye District, 210019, Nanjing, Jiangsu Province, People’s Republic of China;Department of Anesthesiology, Benq medical center & Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, No. 71 Hexi Avenue, Jianye District, 210019, Nanjing, Jiangsu Province, People’s Republic of China;Jiangsu Provincial Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu Province, People’s Republic of China;Department of Anesthesiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China;Jiangsu Provincial Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu Province, People’s Republic of China;

关键词: Cough reflex;    Cuff pressure gauge;    Deflation;    Postoperative airway complications;    Tracheal extubation;   

DOI  :  10.1186/s12871-023-02003-5

 received in 2022-10-12, accepted in 2023-02-01,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe incidence of cough reflex during extubation is 76%. Cough reflex causes severe hemodynamic fluctuations and airway complications. This prospective trial investigated the potential effects of tracheal tube cuff deflation on cough reflex during extubation.MethodsOne hundred and twenty-six patients scheduled for operations within 3 h under general anaesthesia with orotracheal intubation were randomly assigned to one of three groups: control (C), experimental (E) or syringe (S) groups. Patients in group C underwent tracheal tube cuff deflation using a 10-ml syringe in 1 s, patients in group E underwent tracheal tube cuff deflation continuously and slowly in 5 s using a cuff pressure gauge until the pressure was zero and patients in group S underwent tracheal tube cuff deflation using a 10-ml syringe at a speed of 1 ml s−1. The incidence and severity of cough reflexs during extubation and the incidence of postoperative airway complications within 48 h were assessed.ResultsCompared with group C (60.0%), the incidence of cough reflex in group E was 9.8% (p < 0.001) and in group S was 12.5% (p < 0.001). The severity of cough reflex was graded as 2 (1–2) in group C, 1 (1–1) in group E and 1 (1–1) in group S (p < 0.001 for group comparisons). The incidence of hoarseness in group C was 0.0%, in group E was 19.5% and in group S was 5.0% (p < 0.05 for all groups, p = 0.009 between group C and E).ConclusionsCompared with deflating a trachal tube cuff with a 10-ml syringe in 1 s, the use of a 10-ml syringe at a speed of 1 ml s−1 or a cuff pressure guage within 5 s can both reduce the incidence of cough reflex, but deflating with a cuff pressure guage can increase the incidence of postoperative hoarseness.Trial registrationChinese Clinical Trial Registry, identifier: ChiCTR2100054089, Date: 08/12/2021.

【 授权许可】

CC BY   
© The Author(s) 2023

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Fig. 1

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