Maedica · 2026
Endotracheal Tube Cuff Pressure Alterations During Laparoscopic Bariatric Surgery in Morbidly Obese Patients: a Prospective Observational Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Raghuwanshi Jyoti, Chandel Amita, Kapdeo Priyanka Dilip
Аннотация
BACKGROUND: Morbid obesity and laparoscopic bariatric surgery create dynamic airway and respiratory changes that may alter endotracheal tube cuff pressure during general anesthesia.
METHODS: This prospective observational study included 150 morbidly obese adults (body mass index > 40 kg/m2) undergoing elective laparoscopic bariatric surgery under standardized general anesthesia. Endotracheal cuff pressure was initially adjusted to 28 cm H2O and measured with an aneroid cuff manometer at baseline and after gastric calibration tube insertion, creation of carboperitoneum, reverse Trendelenburg positioning, final removal of the gastric calibration tube, return to supine position and release of carboperitoneum. Peak airway pressure, heart rate, blood pressure, oxygen saturation and immediate postoperative airway complaints were also recorded.
RESULTS: Mean cuff pressure increased significantly after gastric calibration tube insertion (36.28 ± 7.29 cm H2O, p<0.001) and after carboperitoneum creation (33.31 ± 3.75 cm H2O, p<0.001), compared with the standardized baseline value of 28.00 ± 0.00 cm H2O. Cuff pressure decreased after gastric calibration tube removal (23.97 ± 2.97 cm H2O, p<0.001) and after release of carboperitoneum (24.73 ± 3.02 cm H2O, p=0.021). Peak airway pressure rose after carboperitoneum and remained elevated until desufflation. Heart rate and oxygen saturation remained stable, whereas systolic and diastolic blood pressure decreased transiently during pneumoperitoneum and head-up positioning. Postoperative airway symptoms were infrequent and mild.
CONCLUSION: Endotracheal cuff pressure changes significantly during laparoscopic bariatric surgery, particularly after gastric calibration tube manipulation and pneumoperitoneum. Routine manometric monitoring and readjustment should be incorporated into intraoperative airway management.
METHODS: This prospective observational study included 150 morbidly obese adults (body mass index > 40 kg/m2) undergoing elective laparoscopic bariatric surgery under standardized general anesthesia. Endotracheal cuff pressure was initially adjusted to 28 cm H2O and measured with an aneroid cuff manometer at baseline and after gastric calibration tube insertion, creation of carboperitoneum, reverse Trendelenburg positioning, final removal of the gastric calibration tube, return to supine position and release of carboperitoneum. Peak airway pressure, heart rate, blood pressure, oxygen saturation and immediate postoperative airway complaints were also recorded.
RESULTS: Mean cuff pressure increased significantly after gastric calibration tube insertion (36.28 ± 7.29 cm H2O, p<0.001) and after carboperitoneum creation (33.31 ± 3.75 cm H2O, p<0.001), compared with the standardized baseline value of 28.00 ± 0.00 cm H2O. Cuff pressure decreased after gastric calibration tube removal (23.97 ± 2.97 cm H2O, p<0.001) and after release of carboperitoneum (24.73 ± 3.02 cm H2O, p=0.021). Peak airway pressure rose after carboperitoneum and remained elevated until desufflation. Heart rate and oxygen saturation remained stable, whereas systolic and diastolic blood pressure decreased transiently during pneumoperitoneum and head-up positioning. Postoperative airway symptoms were infrequent and mild.
CONCLUSION: Endotracheal cuff pressure changes significantly during laparoscopic bariatric surgery, particularly after gastric calibration tube manipulation and pneumoperitoneum. Routine manometric monitoring and readjustment should be incorporated into intraoperative airway management.