Journal article
Frequencies of patient-reported sore throat, hoarseness, dysphagia, and high airway cuff pressures when manometers are used
JCA Advances, Vol.1(3-4), p.100061
12/2024
DOI: 10.1016/j.jcadva.2024.100061
Abstract
Earlier studies of surgical patients' postoperative symptoms from tracheal intubation or supraglottic airway considered sore throat, hoarseness, dysphagia, and coughing as separate endpoints or absent/present.
The retrospective cohort study used data from Mayo Clinic Florida, reported with univariate analyses in the original article. Patients having surgery with tracheal intubation or laryngeal mask airway had symptoms measured upon post-anesthesia care unit discharge. There was a pre-intervention period without the use of cuff manometry (N = 259) and a post-intervention period with the use of cuff manometry (N = 299).
Sore throat, hoarseness, and dysphagia on 1 = none, 2 = mild, 3 = moderate, and 4 = severe scales had estimated pairwise Kendall taub correlations of 0.32, 0.35, and 0.29, respectively, all P < 0.0001. The summated rating of Sore throat, Hoarseness, and Dysphagia (SHeD) had Cronbach's alpha ≈0.66. The probability distribution (N = 553) had a monotonic decrease in frequency from the smallest score of 3 to the largest score of 12. Controlling for tracheal tube or laryngeal mask airway, the use of intraoperative manometry was associated with significantly lower SHeD scores (P < 0.0001). The corresponding effect size was an area under the receiving operating characteristic curve of 0.59 (95% confidence interval 0.54 to 0.64). When manometry was not used, the probability distribution of airway cuff pressures of tracheal tubes was, functionally, two normal distributions, each with approximately half the patients. One normal distribution had an estimated mean of 26 cmH2O (i.e., what was expected with manometry). The other half of the patients' pressures had a mean of 50 cmH2O (i.e., pressures previously associated with obstruction to mucosal blood flow).
Cuff manometry reliably decreased patients' laryngotracheal symptoms, an effect that was detected when analyzed using a summated rating scale for sore throat, hoarseness, and dysphagia. When manometry was not used to check tracheal tube cuff pressures, ≥20% of patients had high (≥50 cmH2O) cuff pressures.
•Postoperative sore throat, hoarseness, and dysphagia were correlated.•Created summated rating of Sore throat, Hoarseness, and Dysphagia (SHeD scale).•Intraoperative cuff manometry use reliably lowered SHeD scores (P < 0.0001).•When manometry was not used, ≥20 % of patients had cuff pressures ≥50 cmH2O.•Earlier studies' heterogeneous results were from absence of use of multivariate analyses.
Details
- Title: Subtitle
- Frequencies of patient-reported sore throat, hoarseness, dysphagia, and high airway cuff pressures when manometers are used
- Creators
- Elena Garrido - University of Iowa, AnesthesiaFranklin Dexter - University of Iowa, AnesthesiaIlana I. Logvinov - Mayo Clinic in FloridaSorin J. Brull - Mayo Clinic in Florida
- Resource Type
- Journal article
- Publication Details
- JCA Advances, Vol.1(3-4), p.100061
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jcadva.2024.100061
- ISSN
- 2950-5534
- eISSN
- 2950-5534
- Language
- English
- Date published
- 12/2024
- Academic Unit
- Anesthesia
- Record Identifier
- 9984821632702771
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