The cuff-leak test on guiding the extubation after transoral atlantoaxial reduction and plate surgery

English Keywords:Cuff-leak test  Transoral atlantoaxial reduction plate  Extubation

English Abstract:

  【Abstract】 Objectives: To evaluate the effect of cuff-leak test on guiding extubation after transoral atlantoaxial reduction and plate(TARP) surgery. Methods: From October 2008 to December 2011, the clinical data of patients experiencing TARP surgery were retrospectively reviewed. All cases were divided into two groups: cuff-leak-test-guided extubation group(n=65) and experience-guided extubation group(n=87). The indication for cuff-leak-test-guided extubation was audible laryngopharyngeal air leak after deflation of the endotracheal tube balloon while ventilating by using an Ambu. While the indication for experience-guided extubation was the swelling degree of body of tongue and posterior wall of pharynx. The differences of reintubation rate and duration of postoperation intubation between 2 groups were compared. Results: There was no significant difference in the reintubation rate between two groups(1.5% in the cuff-leak-test-guided extubation group and 3.40% in the experience-guided extubation group)(P>0.05). The duration of postoperation intubation in the cuff-leak-test-guided extubation group was much shorter than that in experience-guided extubation group(27 cases in <24h, 29 cases in 24-48h and 9 cases in >48h in the former group vs 15 cases in <24h, 36 cases in 24-48h and 36 cases in >48h in the latter, respectively, P<0.01). Conclusions: Compared with experience-guided extubation, cuff-leak test is more reliable to predict the exact time of extubation, which can effectively reduce the duration of postoperation intubation as well as ensure the safety of extubation after TARP surgery.