Background: To discuss whether decreasing the pressure of endotracheal tube cuff slowly with a constant speed can decrease the incidence of coughing during extubation.
Methods: Ninety patients undergoing elective noncardiac surgery under general anesthesia with endotracheal intubation were randomly divided into two groups: group P, the pilot balloon was connected to a syringe and an aneroid manometer through a three-way stopcock, respectively, and the decrease of cuff pressure was controlled at 3 cmHO/s during deflating before extubation; group C, the pressure in endotracheal tube cuff was decreased suddenly with a syringe extracting the air from the cuff rapidly at once exactly before extubation. The incidence of coughing during extubation period was recorded. Mean arterial pressure (MAP) and heart rate (HR) were recorded before general anesthesia induction (T0), just before cuff deflation (T1), immediately after deflation (T2), at 1 min (T3), 3 min (T4), and 5 min after extubation (T5). The occurrence of adverse reactions was also recorded.
Results: The initiation of coughing during extubation period occurs at immediately the time of balloon deflation. Compared with group C, the incidence of coughing was significantly decreased (P = 0.001), MAP and HR were significantly decreased at T2-T4 and T2-T5, respectively (P < 0.05 for all), and the incidence of pharyngolaryngeal discomfort after extubation was significantly reduced (P = 0.021) in group P.
Conclusions: Decreasing the pressure of endotracheal tube cuff slowly with a constant speed can significantly reduce the incidence of coughing during extubating period, stabilize hemodynamics, and reduce the incidence of adverse reactions.
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http://dx.doi.org/10.1186/s13741-024-00450-3 | DOI Listing |
J West Afr Coll Surg
August 2024
Department of Anaesthesia, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Background: Considerable morbidity is attributable to inappropriate tracheal cuff pressure. An earlier study undertaken in our hospital revealed that a normal cuff pressure of 20-30 cm HO was achieved in only 6% of intubated patients using subjective estimation methods.
Objective: To determine whether a training intervention could improve the accuracy of the subjective estimation method in our tracheal cuff monitoring.
Adv Med Educ Pract
December 2024
Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland.
Background: Videolaryngoscopes increased the safety of patients requiring endotracheal intubation. Their particular beneficiaries are healthcare providers inexperienced in intubation. We compared the learning curve of McGrath, UESCOPE, and Airtraq VLs among the first-year anesthesiology residents.
View Article and Find Full Text PDFPleura Peritoneum
December 2024
Odense PIPAC Center (OPC) and Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark.
Objectives: Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) has been suggested as a new therapy for patients with malignant pleural effusion (MPE) and/or pleural metastasis (PLM). The patients have a poor prognosis with a median survival of 3 to 12 months. We present feasibility, patient safety, and cytological/histological response assessment in PITAC-treated patients with MPE and/or PLM.
View Article and Find Full Text PDFAnaesth Crit Care Pain Med
December 2024
Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. Electronic address:
Background: The Gastro-Laryngeal Mask (Jcerity Endoscoper Airway) is a new airway management technique utilized in patients undergoing upper gastrointestinal endoscopy surgery under general anesthesia, but evidence of its effectiveness and safety is scarce.
Objective: To assess the success rate of insertion, cardiovascular response, airway pressure, time taken for placement, nausea or vomiting, pharyngodynia, and other complications of using the new type of back-open gastroscopy laryngeal mask.
Methods: We screened 1401 patients; 105 were ineligible, and 40 declined to participate.
Anesth Analg
December 2024
From the Department of Anesthesiology, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, Texas.
Background: The difficult airway is frequently encountered across many scenarios. The extreme form is a "cannot intubate and cannot oxygenate" scenario, which lacks a reliable rescue technique. Previous case reports or studies with small sample sizes indicate the feasibility and efficiency of an endotracheal tube in the pharynx (TTIP) to ventilate patients.
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