‘Does maintaining endotracheal tube cuff pressures at 20 mm Hg prevent dysphagia and hoarseness after anterior cervical spine surgery?’
A randomised controlled trial.

In anterior cervical spine surgery a retractor is used. Previous studies showed an increase of endotracheal tube cuff pressures after placement of a retractor. It is known that a high endotracheal tube cuff pressure increases the incidence of postoperative dysphagia, hoarseness, and a sore throat. However, until now no evidence supports maintaining the endotracheal tube cuff pressure during anterior cervical spine surgery to prevent this comorbidity.

Our objective is to determine if adjusting endotracheal tube cuff pressure after placement of a retractor during anterior cervical spine surgery prevents postoperative dysphagia. Furthermore laryngo-tracheal complaints (hoarseness and sore throat) will be scored.

Study patients are randomized in two arms. In the control arm endotracheal tube cuff pressure is not adjusted after retractor placement. In the intervention arm endotracheal tube cuff pressure after retractor placement is maintained at 20 mm Hg. Twenty-four hours and 2 months after the operation study patients are questioned about dysphagia, hoarseness and sore throat.

One hundred seventy-seven study patients aged 18-90 years scheduled for anterior cervical spine surgery on 1 or more levels with the use of a retractor will be randomized.

In the control arm no endotracheal tube cuff pressure intervention is performed after retractor application. In the intervention arm the endotracheal tube cuff pressure is maintained at 20 mm Hg after placement and after removal of the retractor. Main study parameters/ end points are postoperative dysphagia, sore throat and hoarseness.

Incidence of post-operative sore dysphagia, sore throat and hoarseness in patients getting anterior cervical spine surgery is not influenced by correction of tube cuff pressure to 20 mm Hg (normal value) after placement of a retractor in the operation wound.

N/A

Study patients are randomized in two arms. In the control arm endotracheal tube cuff pressure is not adjusted after retractor placement. In the intervention arm endotracheal tube cuff pressure after retractor placement is maintained at 20 mm Hg during the length of the operation.