Minimizing adverse effects of subjective measurement of endotracheal tube cuff pressure: Can the use of the loss of resistance technique help?

Abstract

Background: Appropriate endotracheal tube cuff (ETTc) pressure estimation is essential to prevent airway complications. The pilot balloon palpation technique is the commonly used method of cuff inflation. It is however subjective thus prone to over or under estimation thus unreliable.

Objective: To determine if the use of the passive release technique of cuff inflation would reduce commonly encountered airway complications following ETT intubation.

Methodology: Patients scheduled for elective procedures under general anaesthesia with ETT were recruited into the study, 108 ASA I and II patients aged between 18-65 years were randomized into 2 groups with one group having their cuff inflated using the pilot balloon palpation (PBP) technique and the other by the use of a loss of resistance syringe (LOR). Airway complications were then assessed and compared between the 2 groups.

Results: The incidences of sore throat, cough and hoarseness were significantly lower in the LOR group compared to the PBP group (35.2vs79.6%, 14.8 vs64.8% and 7.4 vs 79.6% respectively; p = 0.0001 in each case).

Conclusion: Passive release technique using LOR was found to be less associated with post-endotracheal intubation airway complications than PBP technique