Authors : Pallavi Chauhan, D C Punera, Urmila Palaria, Kamal N Joshi
DOI : 10.18231/j.ijca.2020.093
Volume : 7
Issue : 3
Year : 2020
Page No : 526-532
Introduction: Endotracheal tube is an airway catheter inserted in the trachea to assure patency of the upper
airway. ETT cuff seals the trachea to facilitating positive-pressure ventilation and to prevent aspiration.
The cuff pressure of an endotracheal tube depends on various patient-related factors like obesity, old age,
environmental circumstances and therapeutic interventions. Physiological changes in laparoscopic surgery
under general anesthesia, due to pneumoperitoneum and change in patient position can affect ETT cuff
pressure. These changes in ETT cuff pressure can lead to significant peri-operative adverse outcome.
Aims and Objectives: To evaluate the changes in ETT cuff pressure between open and laparoscopic
cholecystectomy under general anesthesia.
Materials and Methods: 80 ASA grade I/II patients, aged 20-50 years, undergoing laparoscopic or open
cholecystectomy, under GA were included in this prospective observational study. Patients were divided
in two equal sized groups (N=40) for laparoscopic and open cholecystectomy. ETT cuff pressures were
recorded with ETT manometer, at 5 min intervals until extubation. Patients were followed 6 hourly, for 24
hours to record any postoperative complications.
Result: The changes in hemodynamic parameters were more in laparoscopic surgery than open surgery.
Abdominal insufflation in laparoscopic surgery causes significant increase in cuff pressure due to altered
thoracic compliance. Change in position, during laparoscopic surgery, also affects endotracheal tube cuff
pressure.
Conclusion: The pneumo-peritoneum and positional changes during laparoscopic surgery cause
significant increase in endotracheal tube cuff pressure and thus associated with an increased incidence
of post-operative complications.
Keywords: General anaesthesia, Endotracheal tube cuff, Tube cuff pressure, Laparoscopic, Cholecystectomy.