The purpose of this study is to test whether the incidence of sore throat and other tracheal co-morbidities such as dysphagia and hoarseness can be lessened by use of a cuff manometer at the beginning of surgery to inflate to the proper pressure compared to the standard technique.

The investigators hypothesis is that inflation of the endotracheal balloon using a cuff manometer immediately after intubation will reduce the incidence of sore throat and other tracheal co-morbidities.

Inclusion Criteria:

• Scheduled for general anesthesia requiring endotracheal intubation with planned duration of at least 2 hours
• ASA I-3

Exclusion Criteria:

• Planned prolonged intubation
• Planned postoperative ICU admission
• Non English speaking
• Mentally impaired
• Existing tracheal stoma
• Nasogastric tube in place preoperative
• Thyroid / intra-oral surgery
• Previous general anesthesia within the last 2 weeks
• Use of steroids within one week before surgery (IV,inhaled, oral)