The Change of Endotracheal Tube Cuff Pressure During Laparoscopic Surgery

We evaluated the endotracheal tube cuff pressure (P_cuff) changes during pneumoperitoneum for laparoscopic cholecystectomy and the correlations between body mass index (BMI), pneumoperitoneum time, and P_cuff changes.

Total 60 patients undergoing laparoscopic cholecystectomy were allocated to either a study group (BMI ≥ 25 kg/m²) or a control group (BMI < 25 kg/m²). The endotracheal intubation was performed with a high-volume low-pressure cuffed oral endotracheal tube. A manometer was connected to the pilot balloon using a 3-way stopcock and the cuff was inflated. The change in P_cuff was defined as the difference between the pressure just before intra-abdominal CO₂ insufflation and the pressure before CO₂ desufflation.

P_cuff increased to 5.3 ± 3.6 cmH₂O in the study group and 5.7 ± 5.4 cmH₂O in the control group. There was no significant difference between two groups. While BMI was not correlated with change in P_cuff (r = 0.022, p = 0.867), there was a significant correlation between change in P_cuff and the duration of pneumoperitoneum (r = 0.309, p = 0.016).

The change in P_cuff was not affected by BMI and was significantly correlated with pneumoperitoneum time. We recommend regular measurement and adjustment of P_cuff during laparoscopic surgery.