Post-op Sore Throat: Comparing Cuff Pressure and Palpation Methods
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Post-operative Sore Throat: Comparing the Monitored Endotracheal Tube Cuff Pressure and Pilot Balloon Palpation Methods
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Nagappan Ganason, Vanitha Sivanaser, Chian Yong Liu, Muhammad Maaya, Joanna Su Min Ooi
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Post-operative Sore Throat: Comparing the Monitored Endotracheal Tube Cuff Pressure and Pilot Balloon Palpation Methods
Year: 2019 | Doi: 10.21315/mjms2019.26.5.12
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Post-operative sore throat (POST) and hoarseness are common complications associated with general anaesthesia and tracheal intubation. Incidences of POST can range from 11% to 48%, while hoarseness may affect 18% to 53% of patients. These symptoms not only cause patient discomfort but can also impact recovery quality and overall satisfaction. The study aims to compare the effects of two methods of endotracheal tube cuff (ETTc) inflation—measuring cuff pressure versus using the pilot balloon palpation method—on the incidence of POST, hoarseness, and cough post-operatively.
Importance of Cuff Pressure Measurement
The study found that measuring and adjusting the ETTc pressure to 25 cmH₂O significantly reduced the occurrence and severity of POST, hoarseness, and cough in patients compared to those in the pilot balloon palpation group. In Group A, where cuff pressure was measured, 39% experienced POST compared to 75.3% in Group B. Likewise, incidences of hoarseness and cough were significantly lower in Group A. The results suggest that accurately measured ETTc pressure can prevent complications related to over-inflation, which can contribute to tracheal mucosal ischemia and pain. The findings support the recommendation that cuff pressure should be routinely monitored and adjusted to maintain a safe inflation range.
Conclusion
The study concludes that employing a cuff pressure gauge to measure and adjust the ETTc pressure leads to a significant reduction in post-operative complications compared to the traditional pilot balloon palpation technique. Given that a substantial proportion of patients were found to have cuff pressures exceeding safe limits initially, the findings advocate for a shift in clinical practice to include cuff pressure monitoring as a standard procedure in settings involving tracheal intubation, ultimately improving patient outcomes and satisfaction.
FAQ section (important questions/answers):
What is the study focused on regarding endotracheal tube cuffs?
The study compares the impact of measuring endotracheal tube cuff pressure versus the pilot balloon palpation method on post-operative airway complications, specifically focusing on sore throat, hoarseness, and cough.
How were patients grouped in the study?
Patients were randomly assigned to two groups: Group A, where cuff pressure was measured and adjusted to 25 cmH2O, and Group B, where cuff inflation was determined using the pilot balloon palpation method without measurement.
What significant differences were found between the two patient groups?
Group A had lower incidences of post-operative sore throat, hoarseness, and cough compared to Group B, indicating that measuring cuff pressure significantly reduces these complications.
What conclusions were drawn from this study's findings?
The study concluded that adjusting endotracheal tube cuff pressure to 25 cmH2O reduces post-operative complications compared to reliance on the pilot balloon palpation method, which led to higher incidences of discomfort.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Post-op Sore Throat: Comparing Cuff Pressure and Palpation Methods”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In research articles, a table is a systematic arrangement of data, often used to present findings succinctly. Tables facilitate the comparison of variables, such as demographics or outcomes, allowing readers to quickly grasp essential information and relationships without sifting through lengthy text.
2) Study (Studying):
A study refers to a systematic investigation designed to explore a specific hypothesis or research question. In medical contexts, studies can include clinical trials, observational studies, or meta-analyses, and they often aim to improve healthcare practices or enhance understanding of medical conditions.
3) Post:
In this context, 'post' refers to occurrences after a specific event, particularly after surgical procedures or interventions. Postoperative complications, like sore throat or hoarseness, are common concerns for healthcare providers, as they can directly affect patient recovery and satisfaction with care received during hospitalization.
4) Blood:
Blood is a vital bodily fluid that carries oxygen and nutrients to tissues while transporting waste products for elimination. In the context of this research, monitoring blood flow and oxygenation is essential, as inadequate blood supply can result in complications, such as ischemia or tracheal injury.
5) Measurement:
Measurement is the process of quantifying physical quantities. In medical research, precise measurement—such as of endotracheal tube cuff pressure—is crucial for ensuring patient safety. Poor measurement can lead to adverse outcomes like airway complications, highlighting the need for accurate methods in healthcare settings.
6) Attending:
The term 'attending' refers to senior medical professionals who oversee patient care. Attending physicians or anesthesiologists are responsible for guiding treatments, making critical decisions about patient management, and mentoring trainees. Their expertise is particularly crucial during surgeries, ensuring that protocol adherence is maintained.
7) Wall:
In this context, the 'wall' refers to the anatomical structure forming the boundaries of the trachea. Damage or injury to the tracheal wall can result from excessive pressure applied by endotracheal tubes, leading to complications such as necrosis. Hence, careful pressure monitoring is crucial.
8) Animal:
The word 'animal' in medical research often serves as a basis for understanding human biology through studies on animal models. Such studies provide insights into physiological processes, pathology, and potential treatment outcomes, informing best practices in human medicine and surgical interventions.
9) Rules:
Rules are the established guidelines and protocols that govern medical practice and research design. In clinical settings, adherence to rules ensures patient safety and the integrity of the research process. Following regulatory rules enables efficient working relationships among healthcare professionals and researchers.
10) Kaki:
Kaki refers to a specific author or researcher within the provided study who likely contributed to the evaluation of endotracheal tube cuff inflation techniques. Individual researchers play pivotal roles in formulating study designs, interpreting results, and advocating for improved medical practices based on their findings.
11) Pain:
Pain is a subjective sensory and emotional experience that serves as a signal of injury, illness, or distress. It is a critical factor in post-operative recovery, influencing patient satisfaction. Understanding pain levels helps healthcare providers tailor pain management strategies effectively.
12) Hand:
Hand refers to a common term denoting the human body’s extremities, often indicating manual dexterity or surgical skills. In this context, the actions performed by clinicians during intubation or clinical assessments are crucial for ensuring effective patient care and minimizing complications.
13) Male:
The term 'male' denotes a gender category, an essential variable in clinical research. Gender influences physiological responses, risks for specific conditions, and outcomes. Understanding gender disparities can lead to tailored treatments and improved patient care strategies based on biological differences.
14) Inflammation:
Inflammation is the body's biological response to harmful stimuli, such as injury or infection. It's characterized by swelling, redness, heat, and pain. In the context of this study, inflammation can result from overinflation of the endotracheal cuff, potentially causing long-term damage to respiratory tissues.
15) Calculation:
Calculation in medical research refers to the quantitative analysis of data to derive meaningful conclusions. For instance, determining sample size or interpreting statistical significance requires careful calculation. These processes underpin evidence-based medicine, helping to validate study findings and guide clinical practices.
16) Discussion:
The discussion section of a study interprets results, linking findings to existing literature. It allows researchers to explain the implications of their results, consider limitations, and suggest areas for future research. This section is crucial for contextualizing data within broader medical implications.
17) Irritation:
Irritation refers to a feeling of discomfort or inflammation, commonly assessed in post-operative patients. It can result from mechanical trauma or chemical exposure during intubation. Monitoring and addressing irritation is key in post-operative care, ensuring patient well-being and recovery.
18) Medicine:
Medicine is a science and practice concerned with diagnosing, treating, and preventing illness. It encompasses a wide range of disciplines and techniques. The field continually evolves through research and clinical practice, aiming to improve health outcomes and enhance patient care methodologies.
19) Vomiting:
Vomiting is the expulsion of stomach contents through the mouth, often a side effect of anesthesia or postoperative complications. It poses risks during anesthesia recovery. Understanding factors that lead to vomiting helps guide preventive measures for enhanced patient comfort and recovery.
20) Quality:
Quality pertains to the standard of medical care provided, emphasizing patient safety, efficacy, and satisfaction. High-quality care outcomes enhance patient experiences and are essential in clinical practice, where goals focus on minimizing complications like sore throat or other problematic postoperative symptoms.
21) Science (Scientific):
Science refers to the systematic study of the structure and behavior of the physical and natural world through observation and experimentation. In the context of medicine, scientific principles guide research methodologies, treatment decisions, and innovations to improve patient health and safety.
22) Nausea:
Nausea is the sensation of a feeling of unease in the stomach that often precedes vomiting. It is a common side effect of anesthesia and can significantly impact patient recovery. Effective management of nausea enhances overall postoperative experiences and patient satisfaction.
23) Indian:
The term 'Indian' may refer to the demographic characteristics of participants in the study or to specific findings relevant to this population. Understanding ethnic or cultural influences can inform medical practice and ensure tailored approaches in treatments and care strategies.
24) Pulse:
Pulse is the rhythmic expansion and contraction of arteries as blood is pumped through them. Monitoring pulse in patients plays a critical role in assessing cardiovascular function and overall health status during surgical procedures, providing essential information about a patient’s physiological condition.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Post-op Sore Throat: Comparing Cuff Pressure and Palpation Methods’. Further sources in the context of Science might help you critically compare this page with similair documents:
Cough, Surgery, Group A, Patient, Group (b), Medical officer, Sore throat, Sample size, Objective assessment, Visual analogue scale, Neurosurgery, Chi square test, Clinical guidelines, Tertiary centre, Surgical Procedure, Post operative, Multicenter Study, Controlled Study, Surgical patients, General anesthesia, Patient satisfaction, Independent t-test, Group A and B, Local guidelines, Severe cough, Animal Study, General anaesthesia, Difficult intubation, Elective surgery, Nitrous Oxide, Emergency medicine physicians, American Society of Anesthesiologist, Nerve stimulator, Tracheal intubation, Anaesthesiologist, Standard techniques, Endotracheal tube, Endotracheal intubation, Airway management, Mucosal blood flow, Randomised controlled study, Postoperative sore throat, Emergency physician, Intra-operative data, Hoarseness, Operation theatre, Endotracheal tube cuff, ETTc inflation pressure, Pilot balloon palpation method, Post-operative airway complications, Post-operative sore throat, Sore throat incidence, Anaesthesia residents, Cuff pressure gauge, High-volume, low-pressure cuff, Preferential intubation techniques, Quality of recovery, Incidence and severity, Anaesthetic nurse, Tracheal mucosal ischemia, Suctioning procedure, Statistical Package for the Social Science, Neuromuscular blockade, Operating table, Ischaemic injury, AbstractBackgroundEndotracheal tube, Pilot balloon palpation, Double-blind, randomised controlled study, Tracheal mucosa, Cuff inflation pressure, Computer-generated randomised sequence, Anaesthetic nurse or technician, Endotracheal cuff pressure, Oral endotracheal intubation, Post-extubation, Tracheal mucosal blood flow, Airway complications, ETTc pressure measurement, C-MAC Video Laryngoscope, Cuff pressure, Pilot balloon, ETTc pressure, Surgical patient, Hoarseness and cough, Endotracheal tube cuff pressure, Postprocedural complications, Cuff pressure monitoring, Manual vs. automatic method, Tracheal tube cuff pressure, Tracheal wall damage, Pressure volume loop closure, Instrumental versus conventional method, Randomized controlled animal study, Postoperative cuff-related complications, Cuff pressure monitor, AbstractBackgroundEndotracheal tube cuff, Surgical patients requiring intubation, Prospective, double-blind, randomised controlled study, Post-operative hoarseness, Post-operative cough, Inhalational anaesthetic agents, Cuff inflation, Tracheoesophageal fistula, Anaesthetic technician, Attending anaesthesiologists, IV fentanyl, IV propofol, IV rocuronium, Internal diameter ETT, Three-way stopper, Initial cuff pressure, Sevoflurane or desflurane, Fractional inspired oxygen, Standard monitoring procedures, Train-of-four count, Spontaneous respiration, Demographic and intra-operative data, Tracheal simulation model, Aneroid manometer, Experienced anaesthesiologists, Intensive care wards, Fibreoptic bronchoscope, Pressure volume loop, Cuff-related complications, Cuff pressure measurement, Tracheal tube, Mucosal dehydration, Tube cuff pressure monitoring, Tube cuff inflation, Tracheal tube cuff.