JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (15) Citing Articles via Google Scholar Google Scholar Articles by Karasawa, F. Articles by Satoh, T. Search for Related Content PubMed PubMed Citation Articles by Karasawa, F. Articles by Satoh, T.

---

GENERAL ARTICLES

The Effect on Intracuff Pressure of Various Nitrous Oxide Concentrations Used for Inflating an Endotracheal Tube Cuff

Department of Anesthesiology, National Defense Medical College, Tokorozawa, Saitama, Japan

Address correspondence and reprints requests to Fujio Karasawa, MD, Department of Anesthesiology, National Defense Medical College, Tokorozawa, Saitama, 359-8513 Japan. Address e-mail to karasawa{at}me.ndmc.ac.jp

We sought to determine the optimal concentration of nitrous oxide (N₂O) for inflating endotracheal tube cuffs, to avoid overinflation and air leaks. Female patients undergoing endotracheal intubation (inner diameter 7.5 mm) during anesthesia with 67% N₂O were randomly assigned to five groups of 25 subjects each, in which cuffs were inflated with 0% (Air), 30% (N30), 40% (N40), 50% (N50), or 67% (N67) N₂O. The cuff pressure and the N₂O concentration in the cuff were measured. In an additional 15 patients (N40-a group), pilot balloons were replaced with metal tubes, and the mouths and noses of the patients were wrapped with tape, to minimize N₂O efflux into the air. Postoperative sore throats were evaluated in double-blinded interviews. Cuff pressures increased significantly in the Air and N30 groups but decreased in the N67 group. Cuff pressures were <22 mm Hg in the N40 and N50 groups, but the N50 group had air leaks. The N₂O concentration in the cuff in the N40 group was significantly smaller than that in the N40-a group, suggesting N₂O rediffusion. The incidence of sore throats (40% in the Air group) was reduced significantly in the N40 and N50 groups. Therefore, 40% N₂O is optimal for filling the cuff during anesthesia with 67% N₂O.

Implications: Nitrous oxide (N₂O) diffuses into the cuff, equilibrating at a smaller concentration than the gas mixture with which patients are ventilated. Our data indicate that inflation of the cuff with 40% N₂O is recommended to prevent both excessive endotracheal cuff pressure and air leaks during anesthesia with 67% N₂O, reducing postoperative sore throats.

This article has been cited by other articles:

				J.-P. Estebe, M. Gentili, P. Le Corre, G. Dollo, F. Chevanne, and C. Ecoffey Alkalinization of Intracuff Lidocaine: Efficacy and Safety Anesth. Analg., November 1, 2005; 101(5): 1536 - 1541. [Abstract] [Full Text] [PDF]

				A. H. Seymour, B. Prasad, and R. J. McKenzie Audit of double-lumen endobronchial intubation Br. J. Anaesth., October 1, 2004; 93(4): 525 - 527. [Abstract] [Full Text] [PDF]

				J.-P. Estebe, S. Delahaye, P. Le Corre, G. Dollo, A. Le Naoures, F. Chevanne, and C. Ecoffey Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena Br. J. Anaesth., March 1, 2004; 92(3): 361 - 366. [Abstract] [Full Text] [PDF]

				F. Karasawa, A. Takita, T. Mori, I. Takamatsu, Y. Kawatani, and T. Oshima The BrandtTM Tube System Attenuates the Cuff Deflationary Phenomenon After Anesthesia with Nitrous Oxide Anesth. Analg., February 1, 2003; 96(2): 606 - 610. [Abstract] [Full Text] [PDF]

				F. Karasawa, T. Okuda, T. Mori, and T. Oshima Maintenance of stable cuff pressure in the BrandtTM tracheal tube during anaesthesia with nitrous oxide Br. J. Anaesth., August 1, 2002; 89(2): 271 - 276. [Abstract] [Full Text] [PDF]

				F. Karasawa, A. Takita, I. Takamatsu, T. Mori, T. Oshima, and Y. Kawatani Rapid Deflation of the Bronchial Cuff of the Double-Lumen Tube After Decreasing the Concentration of Inspired Nitrous Oxide Anesth. Analg., July 1, 2002; 95(1): 238 - 242. [Abstract] [Full Text] [PDF]

				F. Karasawa, T. Mori, T. Okuda, and T. Satoh Profile Soft-Seal Cuff, a New Endotracheal Tube, Effectively Inhibits an Increase in the Cuff Pressure Through High Compliance Rather than Low Diffusion of Nitrous Oxide Anesth. Analg., January 1, 2001; 92(1): 140 - 144. [Abstract] [Full Text] [PDF]

				F. Karasawa, T. Mori, Y. Kawatani, T. Ohshima, and T. Satoh Deflationary Phenomenon of the Nitrous Oxide-Filled Endotracheal Tube Cuff After Cessation of Nitrous Oxide Administration Anesth. Analg., January 1, 2001; 92(1): 145 - 148. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999