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Effect of continuous measurement and adjustment of endotracheal tube cuff pressure on postoperative sore throat in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial

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Abstract

Background: Postoperative sore throat (POST) is a common complication following endotracheal tube removal, and effective preventive strategies remain elusive. This trial aimed to determine whether actively regulating intraoperative cuff pressure below the tracheal capillary perfusion pressure threshold could effectively reduce POST incidence in patients undergoing gynecological laparoscopic procedures. Methods: This single-center, randomized controlled superiority trial allocated 60 patients scheduled for elective gynecological laparoscopic procedures into two groups: one designated for cuff pressure measurement and adjustment (CPMA) group, and a control group where only cuff pressure measurement was conducted without any subsequent adjustments. The primary outcome was POST incidence at rest within 24 h post-extubation. Secondary outcomes included cough, hoarseness, postoperative nausea and vomiting (PONV) incidence, and post-extubation pain severity. Results: The incidence of sore throat at rest within 24 h after extubation in the CPMA group was lower than in the control group, meeting the criteria for statistically significant superiority based on a one-sided test (3.3% vs. 26.7%, P < 0.025). No statistically significant differences were observed in cough, hoarseness, or pain scores within 24 h post-extubation between the two groups. However, the CPMA group had a higher incidence of PONV compared to the control group. Additionally, the control group reported higher sore throat severity scores within 24 h post-extubation. Conclusions: Continuous monitoring and maintenance of tracheal tube cuff pressure at 18 mmHg were superior to merely monitoring without adjustment, effectively reducing the incidence of POST during quiet within 24 h after tracheal tube removal in gynecological laparoscopic surgery patients.

Trial registration: The study was registered at www.chictr.org.cn (ChiCTR2200064792) on 18/10/2022.

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No datasets were generated or analysed during the current study.

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Funding

This work was supported by the Science and Technology Innovation Fund of Beijing Chaoyang Hospital (Grant number: 22kcjjyb-1).

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Authors and Affiliations

  1. Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Gongrentiyuchang South Road No.8, Beijing, China

    Chen Wang, Xiang Yan, Chao Gao, Simeng Liu, Di Bao, Jia Jiang & Anshi Wu

  2. Department of Clinical Epidemiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

    Di Zhang

Authors
  1. Chen Wang
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  2. Xiang Yan
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  3. Chao Gao
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  4. Simeng Liu
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  5. Di Bao
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  7. Jia Jiang
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  8. Anshi Wu
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Contributions

Study design: CW, XY, SML. Patient recruitment: CW and XY. Data collection: DB, CG, SML. Writing of paper: CW, XY, SML. Manuscript revision: JJ and ASW. Statistical analysis: DZ. Data interpretation: DZ, CW, XY. Final approval of the version to be published: all authors.

Corresponding author

Correspondence to Chen Wang.

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Ethics approval and consent to participate

This trial was approved by the Ethics Committee of Beijing Chaoyang Hospital (serial number 2022-ke-472) on September 5, 2022. All participants voluntarily provided a signed written informed consent.

Competing interests

The authors declare no competing interests.

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Wang, C., Yan, X., Gao, C. et al. Effect of continuous measurement and adjustment of endotracheal tube cuff pressure on postoperative sore throat in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial. J Clin Monit Comput (2024). https://doi.org/10.1007/s10877-024-01173-y

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