2018, Number 3
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Rev Mex Anest 2018; 41 (3)
Measurement of endotracheal tube cuff pressure during transoperative in robotic surgery
Campa-Mendoza ÁN, Gallardo-Castillo E, Frías-Aguirre SE, Torres-Alarcón CG
Language: Spanish
References: 24
Page: 196-206
PDF size: 298.19 Kb.
ABSTRACT
Introduction: During intubation, the cuff pressure the endotracheal tube seals the trachea avoiding aspiration of gastric material. In robotic surgery, the combination of deep Trendelenburg position, capnoperitoneo, hypothermia and time of the procedure can lead to changes in endotracheal tube cuff pressure, increasing tracheal morbidity.
Objective: To determine the changes in endotracheal tube cuff pressure during the transoperative period in patients undergoing prostactomy due to robotic surgery.
Material and methods: Thirty patients were included. Surgical times and endotracheal tube cuff pressure values were measured after the induction of anesthesia (basal T), 120 minutes after initiating CO
2 insufflation (T2h), at 240 minutes (T4h) and prior to extubation (final T.), all measurements were made with a single manometer. A statistical significance associated with a value of p ≤ 0.05 was considered.
Results: The age of the patients was 65.53 ± 5.92 years, the position of trendelenburg with ≥ 30
o 53.3%, the anesthetic and surgical time was 377.3 ± 67.9 min 326.7 ± 77.4 min, respectively. The measurements of the cuff were at two hours 29.6 ± 5.8 cmH
2O, at four hours 28.7 ± 7.6 cmH
2O and at extubation 18.5 ± 7.5 cmH
2O. The pressure of the ETT cuff was higher in the group that presented obesity p ‹ 0.05. In this investigation no changes related to the capnoperitoneum and temperature were presented.
REFERENCES
Latarjet M, Ruiz LA. Anatomía humana: tráquea. 4a ed. 6a reimp. Buenos Aires: Médica Panamericana; 2008. p. 892.
Munguía-Canales DA, Ruiz-Flores J, Vargas-Mendoza GK, Morales- Gómez J, Méndez-Ramírez I, Murata C. Dimensiones traqueales en población mexicana. Cir Cir. 2011;79:505-510.
Gray AW Jr. Endotracheal tubes. Clin Chest Med. 2003;24:379-387.
Busico M, Vega L, Plotnikow G, Tiribelli N. Tubos endotraqueales: revisión. Med Intensiva. 2013;30:1-12.
Trivedi L, Jha P, Bajiya NR, Tripathi D. We should care more about intracuff pressure: The actual situation in government sector teaching hospital. Indian J Anaesth. 2010;54:314-317.
Lomholt N. A device for measuring the lateral wall cuff pressure of endotracheal tubes. Acta Anaesthesiol Scand. 1992;36:775-778.
López-Herranz GP. Intubación endotraqueal : importancia de la presión del manguito sobre el epitelio traqueal. Rev del Hosp Gen Mex. 2016;76:153-161.
Terashima H, Sakurai T, Takahashi S, Saitoh M, Hirayama K. Postintubation tracheal stenosis; problems associated with choice of management. Kyobu Geka. 2002;55:837-842.
Sole ML, Penoyer DA, Su X, Jimenez E, Kalita SJ, Poalillo E, et al. Assessment of endotracheal cuff pressure by continuous monitoring: a pilot study. Am J Crit Care. 2009;18:133-143.
Liu J, Zhang CP, Li Y, Dong S. Post-intubation tracheal stenosis after management of complicated aortic dissection: a case series. J Cardiothorac Surg. 2015;10:148.
Lim H, Kim JH, Kim D, Lee J, Son JS, Kim DC, et al. Tracheal rupture after endotracheal intubation - A report of three cases -. Korean J Anesthesiol. 2012;62:277-280.
Villavicencio-Mavrich H. Cirugía laparoscópica avanzada robótica Da Vinci: origen, aplicación clínica actual en Urología y su comparación con la cirugía abierta y laparoscópica. Actas Urol Esp. 2006;30:1-12.
Lee JR. Anesthetic considerations for robotic surgery. Korean J Anesthesiol. 2014;66:3-11.
Mandel P, Chandrasekar T, Chun FK, Huland H, Tilki D. Radical prostatectomy in patients aged 75 years or older: review of the literature. Asian J Androl. 2017 Sep 26. doi: 10.4103/aja.aja_43_17. [Epub ahead of print]
Wilt TJ, Jones KM, Barry MJ, Andriole GL, Culkin D, Wheeler T, et al. Follow-up of prostatectomy versus observation for early prostate cancer. N Engl J Med. 2017;377:132-142.
Giri S, Sarkar DK. Current status of robotic surgery. Indian J Surg. 2012;74:242-247.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s manual of surgical procedures. 5th edition. Wolters Kluwer. California: Stanford University School of Medicine; 2014.
Gil-Villa SA, Campos-Salcedo JG, Zapata-Villalba MA, López-Silvestre JC, Estrada-Carrasco CE, Mendoza-Álvarez LA, et al. Prostatectomía radical laparoscópica asistida por robot, un año de experiencia en el Hospital Central Militar, reporte de los primeros 55 casos. Rev Mex Urol. 2016;76:87-93.
Kalmar AF, Foubert L, Hendrickx JF, Mottrie A, Absalom A, Mortier EP, et al. Infl uence of steep Trendelenburg position and CO(2) pneumoperitoneum on cardiovascular, cerebrovascular, and respiratory homeostasis during robotic prostatectomy. Br J Anaesth. 2010;104:433-439.
Wu CY, Yeh YC, Wang MC, Lai CH, Fan SZ. Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down position. BMC Anesthesiol. 2014;14:75.
Herrera-Muñoz JA, Gómez-Sánchez J, Preciado-Estrella D, Trujillo- Ortiz L, Sedano-Basilio J, López-Maguey RP, et al. Primer estudio mexicano comparativo entre prostatectomía radical abierta y radical laparoscópica asistida por robot. Rev Mex Urol. 2017;77:173-182.
Valencia M, Ferrer M, Farre R, Navajas D, Badia JR, Nicolas JM, et al. Automatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position: a randomized trial. Crit Care Med. 2007;35:1543-1549.
Pehlivan S, Deniz MN, Sergin D, Ulukaya S. The effect of body position on endotracheal tube cuff pressure in morbidly obese patients. Bariatr Surg Pract Patient Care. 2016;11:165-168.
Lobato EB, Paige GB, Brown MM, Bennett B, Davis JD. Pneumoperitoneum as a risk factor for endobronchial intubation during laparoscopic gynecologic surgery. Anesth Analg. 1998;86:301-303.