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Time required to achieve a stable cuff pressure by repeated aspiration of the cuff during anaesthesia with nitrous oxide

Published online by Cambridge University Press:  11 July 2005

F. Karasawa ,
T. Hamachi ,
I. Takamatsu  and
T. Oshima
F. Karasawa
Affiliation:
National Defense Medical College, Department of Anaesthesiology, Tokorozawa, Saitama, Japan
T. Hamachi
Affiliation:
National Defense Medical College, Department of Anaesthesiology, Tokorozawa, Saitama, Japan
I. Takamatsu
Affiliation:
National Defense Medical College, Department of Anaesthesiology, Tokorozawa, Saitama, Japan
T. Oshima
Affiliation:
National Defense Medical College, Department of Anaesthesiology, Tokorozawa, Saitama, Japan
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Extract

Summary

Background and objective: When the endotracheal tube cuff is repeatedly aspirated to avoid excessive cuff pressure during nitrous oxide anaesthesia, a stable cuff pressure is eventually achieved. We assessed the time required to achieve a stable cuff pressure after repeated cuff deflation.

Methods: During 67% nitrous oxide and oxygen anaesthesia, air-filled cuffs of a standard tracheal tube (Mallinckrodt Hi-Contour®) were repeatedly deflated every 30 min for the first 3 or 4 h to inhibit excessive pressure (Groups Def-3 or Def-4, respectively, n = 10 for each); the cuff pressure was monitored for an additional 3 h. In some patients, the study was terminated at 1, 2, 3 and 4 h (n = 6 for each).

Results: Cuff pressure in Group Def-3, but not in Group Def-4, >22 mmHg after stopping cuff aspiration. Intracuff nitrous oxide concentrations increased during repeated cuff deflation and increased further in Group Def-3 during an additional 3 h (from 39.8 ± 4.7% to 44.3 ± 3.8%; P < 0.05), whereas intracuff nitrous oxide concentrations at 4 h were not different from those in Group Def-4 at the end of the study (43.7 ± 4.5% versus 42.3 ± 4.8%; P = 0.579).

Conclusions: When the air-filled cuff of the standard endotracheal tube is repeatedly deflated every 30 min for 4 h, but not for only 3 h, during nitrous oxide anaesthesia, a stable cuff pressure can be achieved without further deflation of the cuff. Our data also suggest that achieving an equilibrating nitrous oxide concentration in the cuff provides a subsequent stable cuff pressure.

Keywords

ANAESTHETICS, inhalation, nitrous oxideINTUBATION, intratrachealRESPIRATORY SYSTEM, trachea
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 6 , June 2003 , pp. 470 - 474
Copyright
© 2003 European Society of Anaesthesiology

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