Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need

BACKGROUND: To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. METHOD: In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without the use of nitrous oxide) were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. RESULTS: In the 119 patients provided with a tracheal tube, the median cuff pressure was 30 (range 8 - 100) cm H(2)O and the pressure exceeded 30 cm H(2)O (upper recommended level) for 54 patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121) cm H(2)O and above 60 cm H(2)O (upper recommended level) for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H(2)O). There was no association between cuff pressure and age, body mass index, type of surgery, or time from induction of anaesthesia to the time the cuff pressure was measured. CONCLUSION: For maintenance of epithelia flow and nerve function and at the same time secure air sealing, this evaluation indicates that the cuff pressure needs to be checked as part of the procedures involved in induction of anaesthesia and eventually checked during surgery.