The Effect of Position Changing on Endotracheal Tube Cuff Pressure and Post-Operation Sore Throat and Hoarseness in Patients Undergoing General Anesthesia

Tabari, Masoomeh; Rajabi, Faezeh; Moradi, Ali; Sharifian Attar, Alireza

doi:10.22038/ijorl.2025.85571.3870

The Effect of Position Changing on Endotracheal Tube Cuff Pressure and Post-Operation Sore Throat and Hoarseness in Patients Undergoing General Anesthesia

Document Type : Original

Authors

¹ Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

² Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/ijorl.2025.85571.3870

Abstract

Introduction:
Endotracheal intubation is a standard procedure for securing and maintaining the airway during general anesthesia. Cuff pressure must be within the correct range to avoid serious airway complications. This study aimed to assess how the pressure in the endotracheal tube cuff changes when the patient’s position is altered.
Materials and Methods:
This prospective, observational study was conducted on 85 patients aged 18 to 75 undergoing general anesthesia for surgery. Endotracheal intubation was performed with an appropriately sized tube, and the tube cuff was inflated with air using a syringe. The cuff pressure of the endotracheal tube was then assessed using a cuff manometer immediately after intubation and position change, 5 minutes after each, and every 15 minutes until the end of the surgery. Based on the formula for testing the difference between two means for a quantitative trait in two populations, and considering an alpha of 0.05 and a beta of 0.2, the sample size was calculated as 20 individuals in each group of patients with different positions.
Results:
The endotracheal cuff pressure increased in all three positions, including prone, right lateral, and left lateral. A significant relationship was also observed between the sore throat one hour after extubation and the prone position.
Conclusion:
The ETT cuff pressure increased or decreased outside the normal range in most patients undergoing surgeries that require changing positions. Therefore, we recommend close and continuous monitoring of cuff pressure during anesthesia.

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