Evaluation of Changes in Tracheal Cuff Pressure in Patients Undergoing Percutaneous Nephrolithotomy in the Prone Position and its Correlation with Postoperative Sore Throat – A Prospective Observational Study

Background: Theendotracheal cuff is inflated to provide a seal, but over- and under-inflation of the cuff can lead to complications. Our study was designed to evaluate changes in cuff pressure in patients undergoing percutaneous nephrolithotomy (PCNL) in the prone position and its correlation with sore throat. Material and Methods: After institutional Ethical Committee clearance, 70 patients of American Society of Anesthesiologists Physical Status class (ASA) I and II, aged between 18-60 years, posted for elective PCNL were included. The baseline tracheal cuff pressure after intubation and then changes at different study intervals were noted. Postoperative sore throat was assessed at 1, 3, 12 & 24 hours after extubation. Temperature changes, total intravenous fluid & total irrigation fluid used were correlated with the postoperative sore throat. Results: Tracheal cuff pressure significantly decreased in the prone position at the end of surgery (29.4±1.65) from baseline (35.69±1.63) (P <0.001). No participant had a sore throat after 24 hours postoperative, while 1 had (1.4%) severe at 1 hour, 38(54.3%) had minimal and 31(44.3%) had moderate sore throat. There was no correlation with cuff pressure changes and postoperative sore throat (P 0.594). The temperature change, the total amount of intravenous fluid used, the total amount of irrigation fluid, and the duration of surgery did not affect the tracheal cuff pressure. (P > 0.05). Conclusion: Tracheal cuff pressure decreased significantly in patients undergoing PCNL in the prone position, with no correlation between the tracheal cuff pressure changes and the postoperative sore throat.

Keywords: Tracheal cuff pressure, Sore throat, Intratracheal intubation; Prone position; Pharyngitis; Pressure.