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GENERAL ARTICLES

The Brandt^TM Tube System Attenuates the Cuff Deflationary Phenomenon After Anesthesia with Nitrous Oxide

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

Address correspondence to Dr. F. Karasawa, Department of Anesthesiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. Address e-mail to karasawa{at}me.ndmc.ac.jp

The Brandt^TM tube system can limit excessive cuff pressure during nitrous oxide (N₂O) anesthesia, but there is a lack of data assessing whether the Brandt^TM tube system avoids cuff deflation after cessation of N₂O administration. In this study, we recorded air-filled cuff pressures of the Mallinckrodt Brandt^TM or Hi-Contour^TM (control) tracheal tubes (Mallinckrodt, Athlone, Ireland) during 67% N₂O anesthesia and the cuffs were aspirated if the cuff pressure exceeded 22 mm Hg; 180 min later, O₂ was substituted for N₂O. The cuff pressure of both groups significantly decreased after N₂O anesthesia but the time required for the cuff pressure to return to the initial pressure was longer in the Brandt group than in the control group (76.5 ± 35.2 min and 36.5 ± 18.1 min, respectively; P = 0.03). The incidence of air leaks was more frequent in the control group than in the Brandt group (P = 0.015); changes in intracuff N₂O were small in the Brandt group (6.6 ± 1.2% to 3.4 ± 0.9%) compared with those in the control group (46.2 ± 3.8% to 18.6 ± 5.6%). Therefore, the Brandt^TM tube system attenuates the cuff deflationary phenomenon after N₂O anesthesia, whereas repeated cuff deflation during N₂O anesthesia causes cuff deflation after cessation of N₂O, resulting in a possible risk of air leaks.

IMPLICATIONS: We demonstrated that the Brandt^TM tube system attenuates a decrease in cuff pressure after cessation of nitrous oxide (N₂O) administration, whereas a method of repeated cuff deflation to avoid excessive pressure during N₂O anesthesia causes deflationary phenomenon of the cuff after cessation of N₂O administration, resulting in possible risk of air leaks.