title: The effect of endotracheal tube cuff pressure control on postextubation throat pain in orthognathic surgeries: a randomized double-blind controlled clinical trial.
abstract: Pain in the throat after extubation is one of the most common complaints after maxillofacial operations under general anaesthesia. We have evaluated the amount of pain after extubation when we controlled the pressure in the endotracheal cuff during operation by analysing the records of 43 patients who had maxillofacial operations under general anaesthesia. In the study group (n=20) the cuff pressure of the endotracheal tube was adjusted using a pressure gauge at the beginning of intubation and every hour during operation. In the control group (n=23), an experienced anaesthetist adjusted the pressure only at the beginning of the operation by palpating the pilot balloon. Throat pain was evaluated 1, 6, and 24h postoperatively on a visual analogue scale (VAS), and the pain scores in the control and study groups postoperatively was 5.3 (1.1) compared with 3.9 (1.5) (p=0.002); 4.5 (1.3) compared with 3.1 (1.5) (p=0.002); and 1.9 (1.1) compared with 1.6 (1.2) (p=0.4), respectively. The differences between the two groups at 1h and 6h postoperatively were significant, but that at 24h was not. Control of the cuff pressure of the endotracheal tube with a gauge at the beginning of the operation, and adjustment of the pressure during operation, can reduce postoperative complications such as throat pain.
authors.affiliation: Department of Anesthesiology, Azad University of Medical Sciences, Tehran, Iran.
authors.forename: Ladan
authors.initials: L
authors.lastname: Ansari
authors.affiliation: Craniomaxillofacial Research Center and Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Bohluli
authors.affiliation: Oral and Maxillofacial Surgery Department, Azad School of Dental Medicine, Tehran, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Mahaseni
authors.affiliation: Craniomaxillofacial Research Center and Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Valaei
authors.affiliation: Craniomaxillofacial Research Center and Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, Iran. Electronic address: psadr_dds@yahoo.co.uk.
authors.forename: Pooyan
authors.initials: P
authors.lastname: Sadr-Eshkevari
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Ashkan
authors.initials: A
authors.lastname: Rashad
mesh_terms: D000328:Adult; D060666:Airway Extubation / Q000009:adverse effects*; D000768:Anesthesia, General / Q000379:methods; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D061646:Operative Time; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology*; D010608:Pharyngeal Diseases / Q000209:etiology*; D010880:Piperidines / Q000008:administration & dosage; D011312:Pressure; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D000077208:Remifentanil; D064232:Visual Analog Scale
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol
keywords: Anesthesiology; Endotracheal cuff pressure; Endotracheal intubation; Oral surgery; Orthognathic surgery; Randomized controlled clinical trial