Comparison of the Efficacy of Throat Pack in Uncuffed Tube Versus Microcuff® Tubes on Sealing Pressure in Pediatric Laparoscopic Surgeries: A Randomized Clinical Trial

TL;DR

This study compares throat packs with Microcuff® tubes in pediatric laparoscopic surgeries to determine which provides better airway sealing.

Contribution

The study provides empirical evidence on the efficacy of throat packs in uncuffed tubes for pediatric laparoscopic surgeries.

Findings

The uncuffed tube with a throat pack effectively seals the airway during laparoscopic surgeries.

Neither pneumoperitoneum nor Trendelenburg position affected the seal's effectiveness or ventilation.

Postoperative stridor incidence was similar between the two groups.

Abstract

Background and aims

Pneumoperitoneum and extreme Trendelenburg position in laparoscopic surgeries require ventilation at higher peak pressure, potentially resulting in peritubular leak and difficult ventilation. Our study aimed to assess whether a throat pack can provide an adequate seal to prevent peritubular leak around uncuffed tube pediatric laparoscopic surgeries as compared to a Microcuff® tube.

Methods

This randomized clinical trial was carried out on 94 children aged between eight months and five years undergoing laparoscopic surgery under general anesthesia allocated in two parallel groups using a computer-generated random number. We compared sealing pressure, peritubular leak, adequacy of ventilation, quality of capnography, and post-extubation laryngospasm or stridor.

Results

The uncuffed tube with a throat pack effectively seals the airway, and neither the creation of pneumoperitoneum nor the Trendelenburg position affected ventilation or the seal's effectiveness. There was no significant difference in the incidence of postoperative stridor between the two groups.

Conclusion

The throat pack provides an effective seal in an uncuffed tube to perform laparoscopic surgery without increasing airway morbidity.

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