Systematic Review and Meta-Analysis

Impact of Endotracheal Tube Cuff Pressure on Postoperative Sore Throat: A Systematic Review and Meta-Analysis

Bao-Ji Hu , Jian Xu , Xiao-Hong Zhao , Nan-Nan Zhang , Meng-Zhi Pan , Lu-Long Bo , Hong-Wei Duan
Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China, Department of Respiratory Medicine, NO. 101 Hospital of PLA, Wuxi, China, Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China
J Anesth Perioper Med 2016; 3(4): 171- 176 . Published on Jul 25, 2016 . doi:10.24015/JAPM.2016.0022
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Background: Endotracheal tube (ETT) is often necessary to achieve airway control during general anesthesia. Recent studies have showed that sore throat following endotracheal intubation is a common complaint after surgery. The objective of this systematic review and meta-analysis was to estimate whether ETT cuff pressure affects the incidence of postoperative sore throat (POST) after general anesthesia.

Methods: The following databases were searched electronically: PubMed (updated to Nov 2015), EMBASE (updated to Nov 2015), World Health Organization International Clinical Trials Registry Platform (updated to Jul 2015), Chinese BioMedical Literature Database (1978 to Oct 2015), and China National Knowledge Infrastructure (1994 to Oct 2015). Trials comparing EET cuff pressure for elective surgery were included.

Results: Three trials with a total of 609 patients were included in current analysis. Pool results from these trials showed that a lower ETT cuff pressure  significantly decreased the incidence of POST at 24 hours after surgery (relative ratio [RR]=0.76, 95% confidence interval [CI] 0.61-0.95, P<0.05). However, there wasn't any difference between lower and higher cuff pressure on the incidence of POST in post-anesthesia care unit (PACU) (RR=1.00, 95% CI 0.31-3.25, P=1). A lower ETT cuff pressure was not associated with a lower incidence of postoperative hoarseness (PH) at 24 hours after surgery (RR=0.71, 95% CI 0.26-1.92, P=0.50) and in PACU (RR=1.07, 95% CI 0.59-1.93, P=0.82).

Conclusion: Our meta-analysis suggested that lower ETT cuff pressure was associated with a lower incidence of POST in patients undergoing general anesthesia at 24 hours after surgery. However, the exact effect of ETT cuff pressure on patients undergoing general anesthesia deserves further studies.


Citation: Bao-Ji Hu, Jian Xu, Xiao-Hong Zhao, Nan-Nan Zhang, Meng-Zhi Pan, Lu-Long Bo, Hong-Wei Duan. Impact of endotracheal tube cuff pressure on postoperative sore throat: a systematic review and meta analysis. J Anesth Perioper Med 2016; 3: 171-176. doi: 10.24015/JAPM.2016.0022

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