Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down position
Journal
BMC Anesthesiology
Journal Volume
14
Journal Issue
1
Date Issued
2014
Author(s)
Abstract
Background: The abdominal insufflation and surgical positioning in the laparoscopic surgery have been reported to result in an increase of airway pressure. However, associated effects on changes of endotracheal tube cuff pressure are not well established. Methods: 70 patients undergoing elective laparoscopic colorectal tumor resection (head-down position, n = 38) and laparoscopic cholecystecomy (head-up position, n = 32) were enrolled and were compared to 15 patients undergoing elective open abdominal surgery. Changes of cuff and airway pressures before and after abdominal insufflation in supine position and after head-down or head-up positioning were analysed and compared. Results: There was no significant cuff and airway pressure changes during the first fifteen minutes in open abdominal surgery. After insufflation, the cuff pressure increased from 26 ± 3 to 32 ± 6 and 27 ± 3 to 33 ± 5 cmH2O in patients receiving laparoscopic cholecystecomy and laparoscopic colorectal tumor resection respectively (both p < 0.001). The head-down tilt further increased cuff pressure from 33 ± 5 to 35 ± 5 cmH2O (p < 0.001). There six patients undergoing colorectal tumor resection (18.8%) and eight patients undergoing cholecystecomy (21.1%) had a total increase of cuff pressure more than 10 cm H2O (18.8%). There was no significant correlation between increase of cuff pressure and either the patient's body mass index or the common range of intra-abdominal pressure (10-15 mmHg) used in laparoscopic surgery. Conclusions: An increase of endotracheal tube cuff pressure may occur during laparoscopic surgery especially in the head-down position. ? 2014 Wu et al.; licensee BioMed Central Ltd.
Subjects
Endotracheal tube cuff pressure; Head-down position; Head-up position; Laparoscopic surgery
SDGs
Other Subjects
carbon dioxide; abdominal insufflation; abdominal pressure; abdominal surgery; adult; aeration; airway pressure; Article; body mass; body position; cancer surgery; cholecystectomy; colorectal surgery; comparative study; controlled study; correlational study; elective surgery; endotracheal tube cuff; endotracheal tube cuff pressure; female; head down position; head up position; human; laparoscopic surgery; major clinical study; male; middle aged; observational study; open abdominal surgery; patient positioning; pressure; prospective study; supine position; aged; airway resistance; body posture; endotracheal intubation; head; inhalation anesthesia; laparoscopy; patient positioning; pressure; procedures; Adult; Aged; Airway Resistance; Anesthesia, Inhalation; Body Mass Index; Female; Head; Head-Down Tilt; Humans; Intubation, Intratracheal; Laparoscopy; Male; Middle Aged; Patient Positioning; Pressure; Prospective Studies
Type
journal article