Endotracheal Tube Cuff Pressure Increases Significantly During Anterior Cervical Fusion with the Caspar Instrumentation System

• Published in: Anesthesia and analgesia Vol. 76; no. 6; pp. 1318 - 1321
• Main Authors: Sperry, Richard J, Johnson, Joel O, Apfelbaum, Ronald I
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01-06-1993; Lippincott
• Subjects: Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cervical Vertebrae - surgery; Humans; Incidence; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - instrumentation; Medical sciences; Orthopedic Fixation Devices; Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics; Pharyngitis - epidemiology; Pharyngitis - etiology; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Spinal Fusion - instrumentation; Human; Cuff; Surgery; Diseases of the osteoarticular system; Anterior; Cuffed tube; General anesthesia; Intubation; Pressure; Trachea; Cervical spine
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/00000539-199376060-00023

To determine whether endotracheal tube cuff pressure increases significantly with surgical retraction and cervical spine distraction during anterior cervical spine surgery with Caspar instrumentation, we prospectively studied 10 patients undergoing this procedure. The tracheas of all patients were intubated with a Mallinckrodt Hi-Lo® endotracheal tube. Tracheal tube cuff pressures measured with a transducer system were 42.4 mm Hg ± 7.0 mm Hg (SEM) after intubation and cuff inflation. Air was removed from the endotracheal tube cuff until the trachea was just barely sealed at a cuff pressure of 15.2 mm Hg ± 1.6 mm Hg. The endotracheal tube cuff pressure was readjusted to “just-seal” pressure before the surgeons introduced the Caspar instrumentation. The cuff pressure with traction and distraction was 43.2 mm Hg ± 5.0 mm Hg. This pressure was significantly increased from the “just-seal” pressure, and from the cuff pressure after instrumentation was discontinued (9.8 mm Hg ± 2.3 mm Hg). We conclude that anterior cervical spine surgery with Caspar instrumentation is associated with a significant increase in endotracheal tube cuff pressure.(Anes Analg 1993;76:1318-21)