気管内チューブカフ内液体注入によるカフ内圧の検討

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  • Changes in Pressure of Liquid-inflated Endotracheal Tube Cuff Under General Anesthesia with Nitrous Oxide.

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We measured changes in the pressure of liquid-inflated endotracheal tube cuff under general anesthesia with nitrous oxide in 60 adult patients. Anesthesia was induced with thiamylal 5 mg/kg and 6-8mg of vecuronium. Immediately after intubation of endotra-cheal tube (Portex Blue Line®), the cuffs of the tube were inflated with air (n=20) or liquid (normal saline: n=20; lactated Ringer's solution: n=20). The volumes of air or liquid injected into the cuff were determined by the minimum airway pressure to seal the trachea during controlled ventilation. The size of the endotracheal tube for each patient was selected according to the diameter of bronchus shown by chest X-ray. Anesthesia was maintained with 60% nitrous oxide in oxygen and either sevoflurane or isoflurane.<br>Cuff pressures were measured before exposure to anesthetic gases (baseline measure-ments), and were then measured every hour with a standard pressure transducer attached to the tip of the inflating tube.<br>The volumes of air and liquid initially injected into the endotracheal tube cuff were 5.74±1.69 and 6.33±1.71ml, respectively (p%lt;0.05). No significant differences were observed in the baseline values of cuff pressure after inflation of each volume of air and liquid (11.2±3.3 and 10.5±3.5mmHg, respectively). After exposure to 60% nitrous oxide, the pressure of the air-inflated endotracheal tube cuff rapidly increased. However, a gradual decline in pressure was observed in the liquid-inflated endotracheal tube cuff during general anesthe-sia with nitrous oxide. Although changes in the pressure of the liquid-inflated endotracheal tube cuff were observed in patients anesthetized with nitrous oxide, the minimum airway pressure required to cause gas leakage around the cuff showed no significant change in any patient during the study.<br>In conclusion, our results demonstrated that inflation of the endotracheal tube cuff with liquid minimized change in the pressure of the endotracheal tube cuff during nitrous oxide anesthesia.

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