Effect of adjusted cuff pressure of endotracheal tube during thyroidectomy on postoperative airway complications: prospective, randomized, and controlled trial.

Ryu, Jung-Hee; Han, Sun-Sook; Do, Sang-Hwan; Lee, Jung-Min; Lee, Sang-Chul; Choi, Eun-Soo

BACKGROUND Postoperative sore throat (POST) is a common complaint after general anesthesia, especially following thyroidectomy. MATERIALS AND METHODS We examined the effect of adjusting the endotracheal tube cuff pressure during thyroidectomy on the incidence of airway complications. Ninety patients scheduled for elective thyroidectomy were randomized into two groups: control (group A, n = 45) and experimental (group B, n = 45). All patients underwent total intravenous anesthesia with propofol and remifentanil. In group A, the cuff pressure was set to 25 cm H2O initially and then monitored continuously without adjustment during thyroidectomy. In group B, the cuff pressure was maintained at approximately 25 cm H2O throughout the operation. The incidences and the severity of POST, hoarseness, dysphagia, and cough were recorded at 2 and 24 h postoperatively. RESULTS Cuff pressures in group A changed significantly over time (P < 0.05) and were higher than those of group B during thyroidectomy (P < 0.05). The incidences of POST were lower in group B than in group A at 2 and 24 h postoperatively (P < 0.05), and there was a significant difference in the severity of POST at 2 h postoperatively between the two groups. There were no differences in the incidences of hoarseness, dysphagia, and cough between the two study groups (P > 0.05). Adjusting the endotracheal cuff pressure during thyroidectomy decreased the incidence and degree of POST. CONCLUSIONS Intraoperative monitoring and adjustment of the cuff pressure can reduce POST in patients undergoing thyroidectomy.