Effect of continuous measurement and adjustment of endotracheal tube cuff pressure on postoperative sore throat in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial.

IF 2 3区医学 Q2 ANESTHESIOLOGY Journal of Clinical Monitoring and Computing Pub Date : 2024-12-01 Epub Date: 2024-05-11 DOI:10.1007/s10877-024-01173-y

Chen Wang, Xiang Yan, Chao Gao, Simeng Liu, Di Bao, Di Zhang, Jia Jiang, Anshi Wu

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Abstract

Background: Postoperative sore throat (POST) is a common complication following endotracheal tube removal, and effective preventive strategies remain elusive. This trial aimed to determine whether actively regulating intraoperative cuff pressure below the tracheal capillary perfusion pressure threshold could effectively reduce POST incidence in patients undergoing gynecological laparoscopic procedures.

Methods: This single-center, randomized controlled superiority trial allocated 60 patients scheduled for elective gynecological laparoscopic procedures into two groups: one designated for cuff pressure measurement and adjustment (CPMA) group, and a control group where only cuff pressure measurement was conducted without any subsequent adjustments. The primary outcome was POST incidence at rest within 24 h post-extubation. Secondary outcomes included cough, hoarseness, postoperative nausea and vomiting (PONV) incidence, and post-extubation pain severity.

Results: The incidence of sore throat at rest within 24 h after extubation in the CPMA group was lower than in the control group, meeting the criteria for statistically significant superiority based on a one-sided test (3.3% vs. 26.7%, P < 0.025). No statistically significant differences were observed in cough, hoarseness, or pain scores within 24 h post-extubation between the two groups. However, the CPMA group had a higher incidence of PONV compared to the control group. Additionally, the control group reported higher sore throat severity scores within 24 h post-extubation.

Conclusions: Continuous monitoring and maintenance of tracheal tube cuff pressure at 18 mmHg were superior to merely monitoring without adjustment, effectively reducing the incidence of POST during quiet within 24 h after tracheal tube removal in gynecological laparoscopic surgery patients.

Trial registration: The study was registered at www.chictr.org.cn (ChiCTR2200064792) on 18/10/2022.

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持续测量和调整气管导管袖带压力对妇科腹腔镜手术患者术后咽喉痛的影响：随机对照试验。

背景：术后咽喉肿痛（POST）是气管插管拔除后常见的并发症，但有效的预防策略仍未出台。本试验旨在确定积极调节术中袖带压力，使其低于气管毛细血管灌注压力阈值，是否能有效降低妇科腹腔镜手术患者术后咽喉痛的发生率：这项单中心随机对照优效试验将 60 名计划接受妇科腹腔镜手术的患者分为两组：一组指定为袖带压力测量和调整（CPMA）组，另一组为对照组，只进行袖带压力测量，不做任何后续调整。主要结果是拔管后 24 小时内静息状态下的 POST 发生率。次要结果包括咳嗽、声音嘶哑、术后恶心和呕吐（PONV）发生率以及拔管后疼痛严重程度：结果：CPMA 组在拔管后 24 小时内休息时咽喉疼痛的发生率低于对照组，达到了单侧检验的统计学显著优越性标准（3.3% 对 26.7%，P连续监测并将气管导管袖带压力维持在18 mmHg优于仅监测而不调整，可有效降低妇科腹腔镜手术患者拔除气管导管后24 h内安静时POST的发生率：该研究于2022年10月18日在www.chictr.org.cn（ChiCTR2200064792）上注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Monitoring and Computing ANESTHESIOLOGY-

CiteScore

4.30

自引率

13.60%

发文量

144

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Monitoring and Computing is a clinical journal publishing papers related to technology in the fields of anaesthesia, intensive care medicine, emergency medicine, and peri-operative medicine. The journal has links with numerous specialist societies, including editorial board representatives from the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC), the Society for Technology in Anesthesia (STA), the Society for Complex Acute Illness (SCAI) and the NAVAt (NAVigating towards your Anaestheisa Targets) group. The journal publishes original papers, narrative and systematic reviews, technological notes, letters to the editor, editorial or commentary papers, and policy statements or guidelines from national or international societies. The journal encourages debate on published papers and technology, including letters commenting on previous publications or technological concerns. The journal occasionally publishes special issues with technological or clinical themes, or reports and abstracts from scientificmeetings. Special issues proposals should be sent to the Editor-in-Chief. Specific details of types of papers, and the clinical and technological content of papers considered within scope can be found in instructions for authors.