title: Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery: A single-blind, randomized clinical consort study.
abstract: BACKGROUND
  Positional change affects the cuff pressure of an endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of a TaperGuard ETT and a cylindrical ETT after lateral rotation of head during middle ear surgery.
  
  
  METHODS
  Fifty-two patients aged 18-70 years underwent a tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (group C, n = 26) or TaperGuard ETTs (group T, n = 26). After endotracheal intubation, the ETT cuff pressure was set at 22 cmH2O in the neutral position of head. After lateral rotation of head, the cuff pressure was measured again and readjusted to 22 cmH2O. In addition, the change of distance from the carina to the tip of the ETT was measured before and after the positional change. The incidence of cough, sore throat, and hoarseness was assessed at 30 minutes, 6 hours, and 24 hours after surgery.
  
  
  RESULTS
  There was no difference in demographic data between groups. After lateral rotation of head, the cuff pressure significantly increased in group T (11.9 ± 2.3 cmH2O) compared with group C (6.0 ± 1.9 cmH2O) (P < 0.001). The incidence of a cuff pressure >30 cmH2O was higher in group T (96.2%) than in group C (30.8%) (P < 0.001). In addition, the degree of displacement of an ETT was greater in group T (11.0 ± 1.7 mm) than in group C (7.2 ± 2.6 mm) (P < 0.001). The overall incidences of postoperative sore throat, hoarseness, and cough at 30 minutes, 6 hours, and 24 hours after surgery were comparable between two groups.
  
  
  CONCLUSIONS
  The cuff pressure was higher in the TaperGuard ETT than in the cylindrical ETT after positional change of head from neutral to lateral rotation. In addition, after a positional change, the extent of displacement of ETT was greater in the TaperGuard ETT than in the cylindrical ETT.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine Department of Anesthesiology and Pain Medicine, School of Medicine Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Eunkyung
authors.initials: E
authors.lastname: Choi
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Park
authors.forename: Younghoon
authors.initials: Y
authors.lastname: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D004432:Ear, Middle / Q000601:surgery; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D011312:Pressure