To assess the changes of tracheal cuff pressure after a calibrating orogastric tube insertion

Insertion of a medical instrument into the esophagus may affect tracheal tube pressure. This study evaluated the potential effect of a calibrating orogastric tube insertion on tracheal cuff pressure in patients undergoing laparoscopic bariatric surgery. Adult patients who were scheduled for elective bariatric surgery requiring insertion of a calibrating orogastric tube were assessed for eligibility for this study. After successful tracheal intubation, the tracheal tube with a high-volume, low-pressure cuff was adjusted to range from 25 to 30 cmH2O using a manometer. Tracheal cuff pressure was monitored continuously while the calibrating orogastric tube was being advanced. The change of tracheal cuff pressure was recorded after the calibrating orogastric tube had been left in situ for 3 min. After insertion of the calibrating orogastric tube, the median tracheal cuff pressure increased from 28 [27-28 (25-30)] to 36 [30-42 (26-64)] cmH2O (P < 0.001) and was greater than 35 cmH2O in 30 of 60 patients (50 %). Our results suggest that the tracheal cuff pressure should be routinely monitored in patients undergoing laparoscopic bariatric surgery requiring insertion of a calibrating orogastric tube.