Comparison of postoperative sore throat due to cuff inflation of the endotracheal tube using the pilot balloon palpation technique and the minimally occlusive volume technique during total laparoscopic hysterectomy

ABSTRACT

BACKGROUND: Inadequate tube cuff inflation during tracheal intubation can cause complications. Laparoscopic surgery requiring Trendelenburg positioning and maintaining pneumoperitoneum can also result in complications. The focus of our study was to compare the connection between postoperative sore throat and pressure changes associated with methods involving cuff inflation. METHODS: Sixty gynecologic patients undergoing laparoscopic surgery were subjected to the study. The patients were divided into two groups, P and M. Endotracheal tube cuffs were inflated with the pilot balloon palpation technique in group P, while cuffs in group M were inflated with the minimally occlusive volume technique. Cuff pressures were measured with a portable manometer after intubation and before reversing muscle relaxation. Anesthesia was maintained with sevoflurane and N2O. Postoperative sore throat and voice changes were recorded from the PACU until one day after surgery. RESULTS: Initial and final cuff pressure in group P was significantly higher than group M (P < 0.05). Frequency of sore throat and voice change both in the PACU and one day after surgery were higher in group P. Sore throat in group P in the PACU showed higher frequency of grade 2 and 3 than group M. CONCLUSIONS: Minimally occlusive volume technique caused less of an increase in cuff pressure than the pilot balloon palpation technique, resulting in less complications such as sore throat. Therefore, this technique is helpful in reducing postoperative sore throat and complications during laparoscopic surgery. However, it is noted that these assumptive methods are less accurate than direct measurement with a manometer.