Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down positionReportar como inadecuado

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BMC Anesthesiology

, 14:75

Airway and respiratory management


BackgroundThe 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.

Methods70 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.

ResultsThere 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.

ConclusionsAn increase of endotracheal tube cuff pressure may occur during laparoscopic surgery especially in the head-down position.

KeywordsEndotracheal tube cuff pressure Laparoscopic surgery Head-down position Head-up position Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-14-75 contains supplementary material, which is available to authorized users.

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Autor: Chun-Yu Wu - Yu-Chang Yeh - Ming-Chu Wang - Chia-Hsin Lai - Shou-Zen Fan


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