Authors
1
Al-Hamdaniyah Hospital,Mosul, Iraq
2
Ghazi Al-Hariri for Specialized Surgeries Teaching Hospital, Baghdad, Iraq
,
Document Type : Research Paper
Abstract
Postoperative hoarseness of voice and sore throat are most common undesirable outcome at postoperative period. They are attributed to mucosal dehydration or edema, tracheal ischemia due to relatively high cuff pressure during endotracheal intubation. However, other demographic and perioperative factors could also have their own influence.
Our study aimed to assess the cuff pressure with the incidence of postoperative hoarseness and sore throat.
This experimental clinical trial included (60) consecutive adult patients undergoing elective surgery who required endotracheal intubation. The patients were divided into two equal groups according to cuff pressure: with low cuff pressure (25 cmH2O) and high cuff pressure (28 cmH2O). The incidence of postoperative hoarseness and sore throat during the first 24 to 72 hours post operation was recorded.
The results showed that none of demographic or clinical factors of the patients had a significant effect on the incidence of hoarseness and sore throat. The overall incidence of hoarseness and sore throat was (16.67%) and (13.33%), respectively. Hoarseness and sore throat were more common in high pressure group (26.67% and 23.33%, respectively) than low pressure group (6.67% and 3.33%, respectively) with significant differences.
It can be concluded from the current study that the high cuff pressure (28 cmH2O) was associated with increased incidence of postoperative hoarseness and sore throat.
- Dorsch JA, Dorsch SE. Understanding Anesthesia Equipment. 5th ed. Philadelphia: Williams and Wilkins; 2008:181.
- Hamdan AL, Kanazi G, Rameh C, Rifai H, Sibai A. Immediate post‑operative vocal changes in patients using laryngeal mask airway versus endotracheal tube. J Laryngol Otol 2008;122:829‑
- Tennant I, Augier R, Crawford-Sykes A, Ferron-Boothe D, Meeks- Aitken N, Jones K, et al. Minor postoperative complications related to anesthesia in elective gynecological and orthopedic surgical patients at a teaching hospital in Kingston, Jamaica. Rev Bras Anestesiol 2012;62:188-98.
- Renner B, Mueller CA, Shephard A. Environmental and non- infectious factors in the aetiology of pharyngitis (sore throat). Inflamm Res 2012;61:1041-52.
- Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth 2002;88:582-84.
- Yu SH, Beirne OR. Laryngeal mask airways have a lower risk of airway complications compared with endotracheal intubation: a systematic review. J Oral Maxillofac Surg 2010;68:2359-76.
- Liu J, Zhang X, Gong W, et al. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: a multicenter study. Anesthesia and Analgesia 2010;111:1133- 37.
- Ansari L, Bohluli B, Mahaseni H, Valaei N, Sadr‐Eshkevari P, Rashad A. The effect of endotracheal tube cuff pressure control on postextubation throat pain in orthognathic surgeries: a randomized double‐blind controlled clinical trial. British Journal of Oral and Maxillofacial Surgery 2014;52: 140-
- Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002 ;88:582-84.
- Christensen AM, Willemoes-Larsen H, Lundby L, Jakobsen KB. Postoperative throat complaints after tracheal intubation. Br J Anaesth. 1994;73:786-87.
- Lee JY, Sim WS, Kim ES, et al. Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients. J Int Med Res. 2017;45:744-52.
- Liu J, Zhang X, Gong W, Li S, Wang F, Fu S, Zhang M, Hang Y. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: a multicenter study. Anesth Analg. 2010;111:1133-37.
- Nseir S, Duguet A, Copin MC, De Jonckheere J, Zhang M, Similowski T, Marquette CH. Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study. Crit Care 2007;11:R109.
- Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed) 1984;288:965–68.
- Liu J, Zhang X, Gong W, et al. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: a multicenter study. Anesth Analg 2010;111:1133–37.
- Gemechu BM, Gebremedhn EG, Melkie TB. Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014. Pan Afr Med J. 2017;27:127.
- Sanou J, Ilboudo D, Rouamba A, Traore O. Sore throat after tracheal intubation. Canadian Journal of Anesthesia.1996; 44: 203-6.
- Matsuo K, Matsuda M, Yamasaki M, Hirata M, Amaya F. [Risk Factors for the Postsurgical Hoarseness Contribution of the Intubation Device]. Masui. 2017;66:383-86.
- Edomwonyi NP, Ekwere IT, Omo E, Rupasinghe. Postoperative throat complication after tracheal intubation. Annals of African Medicine. 2006;5:28-32.
- Juvin P, Lavaut E, Dupont H, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg 2003;97:595–600.
- Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta- analysis of bedside screening test performance. Anesthesiol 2005;103:429e37.