Safety and reliability of the sealing cuff pressure of the microcuff pediatric tracheal tube for prevention of post-extubation morbidity in children: a comparative study

The objective of this study is to evaluate the efficacy and safety of sealing pressure as an inflation technique of the Microcuff pediatric tracheal cuffed tube. A total of 60 children were enrolled in this study. After induction of anesthesia and intubation with Microcuff pediatric tracheal tube, patients were randomly assigned, to one of the three groups. Control group [n = 20] the cuff was inflated to a cuff pressure of 20 cm H 2 O; sealing group [n = 20] the cuff was inflated to prevent the air leak at peak airway pressure of 20 cm H 2 O and the finger group [n = 20] the cuff was inflated to a suitable pressure using the finger estimation. Tracheal leak, incidence and severity of post-extubation cough, stridor, sore throat and hoarseness were recorded. The cuff pressure as well as the volume of air to fill the cuff was significantly low in the sealing group when compared with the control group [P < 0.001]; however, their values were significantly high in the finger group compared with both the control and the sealing group [P < 0.001]. The incidence and severity of sore throat were significantly high in the finger group compared with both the control and the sealing group [P = 0.0009 and P = 0.0026]. Three patients in the control group developed air leak around the endotracheal tube cuff. The incidence and severity of other complications were similar in the three groups. In pediatric N 2 O, free general anesthesia using Microcuff pediatric tracheal tub, sealing cuff pressure is safer than finger palpation technique regarding post-extubation morbidities and more reliable than recommended safe pressure in prevention of the air leak

Does intra-cuff alkalinized lidocaine prevent tracheal tube induced emergence phenomena in children?

To study and investigate the efficacy of intra-cuff alkalinized lidocaine in the prevention of the endotracheal tube [ETT] induced emergence phenomena in children.Fifty children, ages 6-12 years, ASA physical status I-II, scheduled for elective dental surgery under N2O free general anesthesia with an expected duration of 120 min or more, were randomly assigned one of the two groups [25 patients each]; lidocaine group in which the cuff of ETT was inflated with a mixture of lidocaine 2% and sodium bicarbonate 8.4% and the saline group, in which tube cuff was inflated with 0.9% saline solution.There were significant reduction in the incidence and severity [p=0.005 and p= 0.014] of cough at extubation and in the PACU [P=0.048 and P=0.014]. The incidence and severity of postoperative sore throat was also reduced in the lidocaine group compared to the saline group [p=0.025 and 0.031 respectively]. Moreover, there was a significant prolongation of the time to spontaneous ventilation before extubation in the lidocaine compared to the control group [16.4 +/- 3.1 min and 9.4 +/- 1.7 min respectively] with p value < 0.0001. Intra-cuff alkalinized lidocaine reduces the incidence of cough, sore throat, improved ETT tolerance and inducing smooth extubation in paediatric patients, but prolongs time to spontaneous ventilation before extubation

sealing cuff pressure, easy, reliable and safe technique for endotracheal tube cuff inflation?: a comparative study

To compare the three common methods of endotracheal tube cuff inflation [sealing pressure, precise standard pressure or finger estimation] regarding the effective tracheal seal and the incidence of post-intubation airway complications. Seventy-five adult patients scheduled for N 2 O free general anesthesia were enrolled in this study. After induction of anesthesia, endotracheal tubes size 7.5 mm for female and 8.0 mm for male were used. Patients were randomly assigned into one of three groups. Control group [n=25], the cuff was inflated to a pressure of 25 cm H 2 O; sealing group [n=25], the cuff was inflated to prevent air leaks at airway pressure of 20 cm H 2 O and finger group [n=25], the cuff was inflated using finger estimation. Tracheal leaks, incidence of sore throat, hoarseness and dysphagia were tested. Although cuff pressure was significantly low in the sealing group compared to the control group [P<0.001], the incidence of sore throat was similar in both groups. On the other hand, cuff pressure as well as the incidence of sore throat were significantly higher in the finger group compared to both the control and the sealing group [P<0.001 and P=0.008]. The incidence of dysphagia and hoarseness were similar in the three groups. None of the patients in the three groups developed air leak around the endotracheal tube cuff. In N 2 O, free anesthesia sealing cuff pressure is an easy, undemanding and safe alternative to the standard technique, regarding effective sealing and low incidence of sore throat