J Korean Neurosurg Soc.  2006 Jun;39(6):419-422.

Postoperative Tracheal Mucosa Ischemia by Endotracheal Tube Cuff Pressure Change During the Anterior Cervical Spine Surgery

Affiliations
  • 1Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea. chosunns@hanmail.net

Abstract


OBJECTIVE
Endotracheal tube cuff-pressure(ETCP) increases significantly during anterior cervical spine surgery with neck retraction. Clinically, postoperative hoarseness with sore throat is correlated with vocal cord edema due to longer intubation time and higher ETCP during neck retraction.
METHODS
Fifty patients of anterior cervical spine surgery were randomized to a control (no adjustment, 25 cases) and a treatment group (ETCP adjusted to 20mmHg, 25 cases). Patients were blinded to their group assignments. They were questioned about the presence of ischemic symptoms (sore throat, dysphagia, hoarseness) postoperatively at different time points; 4 hours, 24 hours, and 1 week postoperatively.
RESULTS
No differences between groups at 4 hours and 1 week postoperatively were demonstrated. At 24 hours, 36% of patients in the treatment group complained of sore throat while 56% of control group patients did (p<0.05). Female patients correlated with development of all ischemic discomfort (p<0.05: sore throat, hoarseness, dysphagia).
CONCLUSION
Our results suggest that postoperative ischemic symptom following anterior cervical spine surgery may be associated with the two predictors; increased ETCP during neck retraction and female. The simple procedure of maintaining ETCP to 20mmHg can prevent postoperative tracheal ischemic symptom.

Keyword

Anterior cervical spine surgery; Endotracheal tube cuff-pressure(ETCP); Sore throat; Dysphagia; Hoarseness

MeSH Terms

Deglutition Disorders
Edema
Female
Hoarseness
Humans
Intubation
Ischemia*
Mucous Membrane*
Neck
Pharyngitis
Pharynx
Spine*
Vocal Cords
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