Effect of Tracheal Cuff Shape on Intracuff Pressure Change During Robot-Assisted Laparoscopic Surgery: The Tapered-Shaped Cuff Tube Versus the Cylindrical-Shaped Cuff Tube.
BACKGROUND
Although the cuff of tracheal tubes can reduce airflow leakage and prevent aspiration, excessive intracuff pressure can cause tracheal mucosal injury. Robot-assisted laparoscopic surgery (RALS) can increase intracuff pressure by the Trendelenburg position and pneumoperitoneum. The aim of our current study was to investigate the effect of tracheal cuff shape on the intracuff pressure increase by comparing two different-shaped cuffs during RALS.


METHODS
Ninety-eight patients undergoing RALS were allocated randomly into two groups (tapered-shaped cuff [TSC] and cylindrical-shaped cuff [CSC] groups). The intracuff pressure was measured at nine specific time points: after intubation, immediately after surgical preparation (Trendelenburg position with CO2 insufflation), at 5, 10, 15, 30, 60, and 90 minutes after surgical preparation, and at the end of surgery. Postintubation airway symptoms were measured by assessing sore throat, hoarseness, and excessive cough 1 hour after postanesthesia care unit admission.


RESULTS
Intracuff pressure significantly increased during surgery in both groups. The trend of intracuff pressure change decreased in the TSC group compared with the CSC group, although no statistically significant changes were found (P=.450). Also, there were no statistically significant differences in the postintubation airway symptom between the two groups.


CONCLUSIONS
The TSC tube has a tendency to decrease intracuff pressure change compared with the CSC tube during RALS. However, neither of them was beneficial in preventing intraoperative intracuff pressure increase during RALS.
1 Department of Anesthesia and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine , Seoul, Korea.
Hyungseok
H
Seo
2 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea.
Ji-yeon
JY
Bang
2 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea.
Jimi
J
Oh
2 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea.
Woo-jong
WJ
Choi
2 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea.
Jun-gol
JG
Song
2 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea.
Gyu-sam
GS
Hwang
D002763:Cholecystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011312:Pressure; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome