Effect of Fixed Tracheal Cuff Volume vs Fixed Tracheal Cuff Pressure on Hemodynamic Parameters and Postoperative Airway Complications, A Prospective Randomized Control Trial in a Tertiary Care Hospital

Ravikanth Pula; Swapna Katakam; Gooty Sunanda; Nagarjuna Thakur

doi:10.18502/aacc.v9i1.11938

Ravikanth Pula Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India.
Swapna Katakam Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India.
Gooty Sunanda Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India.
Nagarjuna Thakur Department of Anesthesiology, ESIC Medical College and Superspeciality Hospital, Sanath Nagar, Hyderabad, India.

DOI: https://doi.org/10.18502/aacc.v9i1.11938

Keywords: Tracheal cuff pressure; Hemodynamic parameters; Anaesthesia; Hoarseness; Cough; Sore throat

Abstract

Background: The current study is aimed to compare the effect of fixed cuff volume and fixed cuff pressure technique on hemodynamic parameters and on postoperative complications.

Methods: The prospective, randomised, controlled study was conducted in a tertiary care hospital with 100 patients aged between 18 to 60 yrs. The patients who are undergoing for elective surgeries under general anaesthesia were enrolled after obtaining ethical committee approval. Patients were randomized based on computer generated random numbers into two groups, fixed volume (7ml) group (group V, n-50) and fixed cuff pressure group (group P, n-50). The ETT cuff was filled with 7 ml of air in the fixed volume technique, and in the fixed cuff pressure group -cuff pressure was maintained at 20 cmH2O, after intubation. Tracheal tube cuff pressures were measured by AMBU cuff pressure gauge manometer. Hemodynamic parameters SBP, DBP, MAP and PR were noted at the time of cuff inflation, after extubation in the both the groups. Post-operative sore throat, hoarseness and cough was assessed at the time of extubation in the both the groups.

Results: Mean age in both the groups was 41 years. Statistical significance (P< 0.0001) was observed in Group P in systolic blood pressure (SBP), diastolic blood pressure (DBP), MAP, HR whereas no significance was seen in group V. The percentage of post-operative complications like hoarseness, cough, sore throat, and dysphagia were seen to be less in group P when compared to group V.

Conclusion: With present data we could conclude that the fixed minimal cuff pressure (20 mm H2O) is an ideal and reliable technique in reducing the post-operative complications along with maintenance of hemodynamic parameters.