Anterior servikal omurga cerrahisi sonrası farklı endotrakeal tüp kaf basınçlarının disfajı üzerine etkileri

Amaç: Bu çalışmada, anterior servikal omurga cerrahisinde iki farklı endotrakeal kaf basıncının postoperatif disfaji, boğaz ağrısı, disfoni ve hastanede kalış üzerindeki etkilerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Cerrahi planlanan 70 hasta rastgele iki gruba ayrıldı. Entübasyondan sonra endotrakeal kaf basıncı Grup I'de (n=35) ve Grup II'de (n=35) sırasıyla 20 cmH2O ve 25 cmH2O'ya şişirildi. Disfajinin derecesi Bazaz disfaji skoru ile değerlendirildi. Boğaz ağrısı Görsel Analog Skala ile değerlendirildi. Operasyon bölgesine ilişkin toplam ağrı skoru VAS kullanılarak değerlendirildi (. Ses kısıklığı, seste herhangi bir değişiklik olup olmamasına göre sert veya gergin olarak değerlendirildi. Disfaji, disfoni ve boğaz ağrısı ameliyat sonrası 1. ve 24. saatlerde değerlendirildi. Bulgular: Gruplar arasında demografik verilerde farklılık yoktu. Ameliyat sonrası 1. ve 24. saatlerde yutma güçlüğü ve boğaz ağrısı Grup I'de Grup II'ye göre anlamlı olarak daha azdı. Disfoni sıklığı Grup I'de Grup II'ye kıyasla sadece cerrahi sonrası 1. saatte anlamlı olarak daha azdı. Gruplar arasında ameliyat sonrası 1. ve 24. saatlerde VAS skorlarında fark yoktu. Sonuç: Bu çalışmada, 25 cmH2O'ya kıyasla endotrakeal kaf basıncı 20 cmH2O ile cerrahi sonrası disfaji gelişme riskinin önemli ölçüde azalttığı gösterilmiştir. Ayrıca, daha düşük kaf basıncı, daha hafif bir boğaz ağrısı, ameliyat sonrası 1. saatte daha az ses kısıklığı ve daha kısa hastanede kalış süresi ile ilişkilendirildi.

Effects of different endotracheal tube cuff pressures on dysphagia after anterior cervical spine surgery

Purpose: The present study aimed to compare the effects of two different endotracheal cuff pressures on postoperative dysphagia, sore throat, dysphonia, and hospital stay in anterior cervical spine surgery. Materials and Methods: Seventy patients scheduled for surgery were randomly divided into two groups. After intubation, the endotracheal cuff pressure was inflated to 20 cmH2O and 25 cmH2O in Group I (n=35) and Group II (n=35), respectively. The degree of dysphagia was assessed with the Bazaz dysphagia score. The sore throat was evaluated via Visual Analog Scale. Total pain score regarding the operation site was evaluated using VAS. Hoarseness was evaluated based on the presence of any changes to the voice asharsh or strained. Dysphagia, dysphonia, and sore throat were assessed on the postsurgical 1st and 24th hours. Results: No differences in demographic data were present between the groups. Dysphagia and sore throat at the postsurgical 1st and 24th hours were significantly lesser in Group I than in Group II. The frequency of dysphonia was significantly less in Group I than compared to Group II only at the post-surgical 1st hour. No differences in VAS scores at the post-surgical 1st and 24th hours were present between the groups. Conclusion: In this study, it was shown that the risk of developing dysphagia after surgery was significantly reduced with 20 cmH2O endotracheal cuff pressure compared to 25 cmH2O. Also, lower cuff pressure was associated with a milder sore throat, less hoarseness at 1 hour postoperatively, and a shorter hospital stay.

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