THE EFFECT OF CHANGE IN POSITION ON INTRATRACHEAL CUFF PRESSURE IN PATIENTS UNDERGOING SURGERY WITH GENERAL ANESTHESIA: A PROSPECTIVE ANALYTICAL STUDY

Tracheal intubation with a cuffed tube for the administration of general anesthesia is routine. The cuff of the endotracheal tube is inflated with air to achieve an adequate seal to prevent aspiration and leakage of air and anesthetic gases. Whereas over-inflation can decrease the mucosal perfusion, leading to pressure necrosis and nerve palsies. This study aimed to evaluate the change in ETT cuff pressure by changing the position from supine to prone and lateral decubitus without head movement.

During this prospective analytical study, fifty-five patients candidate for surgery under general anesthesia with lateral or prone positions were enrolled. The initial base pressure of the ETT cuff was measured, and the cuff pressure was subsequently adjusted to a normal range. The cuff pressure then was measured after applying the prone or lateral positions and at the end of operation when the patient had the supine position.

The cuff pressure increased significantly after changing position from supine to prone (27.06±2 vs. 36.87 ± 9 cmH2O, p < 0.001). Also, significant increase in cuff pressure was also observed after changing position from supine to lateral decubitus (27.95 ±3 vs. 40.81 ± 10 cmH2O, p < 0.001).

The position change from supine to prone and supine to lateral decubitus without head movement can cause an increase in the endotracheal tube cuff pressure. The necessity of routine monitoring of cuff pressure in these patients is recommended.