An Observational Study on the Incidence of Postoperative Sore Throat in Relation to Endotracheal Tube Cuff Pressures in Kenyatta National Hospital Main Theatre

Abstract

Introduction The endotracheal tube cuff prevents aspiration and air leak during positive pressure ventilation. The recommended cuff pressures lie between 20 -30 cmH20. Cuff pressures above the recommended range can result in complications ranging from postoperative sore throat to tracheal rupture. Objective To determine the incidence of postoperative sore throat in relation to endotracheal tube cuff pressures in patients undergoing surgery at the Kenyatta National Hospital. Methods Patients were recruited at the Kenyatta National Hospital theatre complex. Suitability for inclusion was assessed. Once anaesthetized, cuff pressures were assessed immediately after inflation. Subsequent measurements were done at intervals until the completion of the procedure. Assessment of POST began in PACU when the patient achieved a Ramsay sedation score of 2. Assessment of POST continued in the ward at 6, 12 and 24 hours Results 120 patients were recruited. Endotracheal tube cuff pressures were found to be elevated in 94.2% of patients. The mean cuff pressure was 59.1 cmH20. The incidence of sore throat was 61.9 %. There were greater odds of developing sore throat with higher endotracheal tube cuff pressures (odds ratio 3.78). Nitrous oxide was found to be significantly associated with sore throat (p=0.038). Conclusion Endotracheal tube cuffs were inflated to pressures above the normal limit in 94.2% of patients. 61.9% of patients developed postoperative sore throat.