The Effect of Lumbar Disc Hernia Operations in Prone Position on Endotracheal Cuff Pressure and Tracheal Morbidity

Abstract

Background: When the cuffs of endotracheal tubes are inflated with high pressure, serious morbidities are encountered. The aim of our study is to monitor the values of endotracheal tube cuff pressure, which can change in different positions, during the operation and to investigate its effects on tracheal morbidity. Materials and Methods: Prospective observational study. The age at which general anesthesia with endotracheal intubation was applied to the study; Sixty randomly selected patients in the ASA 1-2 group, 18-80 years old, and Mallampati class 1-2 were included between July 2016 and July 2017. Thirty patients with lumbar disc herniation surgery were divided into 2 groups as group 1 in the prone position, and group 2 in the supine position of 30 patients with lower or upper extremity surgery. After the patients in both groups were intubated in the supine position, the pilot balloon was inflated with an endotracheal cuff manometer between 28-30 cmH2O. Endotracheal tube cuff pressure was continuously monitored throughout the entire operation and recorded every 5 minutes. The patients were evaluated in terms of cough, dysphonia and sore throat at 1, 8 and 24 hours postoperatively. Results: Hemodynamic and respiratory parameters and temperature values of the groups were recorded during the operation. Cuff pressures, postoperative cough, hoarseness and sore throat were statistically significantly higher in group 1 (p:0.0001). Conclusion: In order to minimize tracheal morbidity and related complications that may develop due to endotracheal intubation, it was concluded that cuff pressure monitoring should become standard and continuous measurement is required, especially in operations in the prone position.