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The endotracheal intracuff pressure is to be maintained at a low level to prevent trachea and nerve damages, and yet be high enough to secure air sealing. The objective of the study is to compare minimal occlusive volume technique (MOVT) and expired volume/inspired volume ratio (VE/VI ratio) from a spirometer method of endotracheal tube (ETT) cuff inflation with respect to the cuff pressure required to seal the airway during a laparoscopic surgery under general anesthesia. A study design is a randomized crossover trial in 35 patients. The primary outcome is the intracuff pressure of an endotracheal tube. The study consists of two cuff sealing methods separated by a period of 10 minutes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cuff sealing by MOVT | Active Comparator | MOVT (minimal occlusive volume technique). The cuff sealing will be confirmed with MOVT, then the intracuff pressure will be measured. |
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| Cuff sealing by VE/VI ratio | Active Comparator | VE/VI ratio of Spirometer. The cuff sealing will be confirmed with VE/VI ratio of a spirometer, then the intracuff pressure will be measured. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MOVT | Procedure | ETT cuff will be inflated till the disappearance of audible air leak on auscultation, while abdominal carbon dioxide (CO2) inflation is maintained with peak inspiratory pressure of 25 cm H2O during volume controlled ventilation. The patient will be in the Trendelenburg position. |
| Measure | Description | Time Frame |
|---|---|---|
| Intracuff Pressure | The intracuff pressure of endotracheal tube when cuff sealing is achieved. | From the start of cuff inflation to the airway sealing, an average of 2 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Intracuff air volume | The intracuff air volume of endotracheal tube when cuff sealing is achieved. | From the start of cuff inflation to the airway sealing, an average of 2 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Junyong In, MD, PhD | DongGuk University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dept. of anesthesiology and pain medicine, Dongguk University Ilsan Hospital | Goyang | Gyeonggido | 10326 | South Korea |
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Two methods of cuff sealing will be applied in a random sequence to each patient.
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The randomization table of a treatment sequence will be managed by the third person who will not involve in this study.
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| VE/VI ratio of Spirometer | Procedure | ETT cuff will be inflated till the VE/VI ratio meets the initial VE/VI ratio, while abdominal CO2 inflation is maintained with peak inspiratory pressure of 25 cm H2O during volume controlled ventilation. The patient will be in the Trendelenburg position. |
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