J Anesth Perioper Med. 2016;3(4):171-176. https://doi.org/10.24015/ebcmed.japm.2016.0022

Impact of Endotracheal Tube Cuff Pressure on Postoperative Sore Throat: A Systematic Review and Meta-Analysis

Bao-Ji Hu1*, Jian Xu2*, Xiao-Hong Zhao1*, Nan-Nan Zhang1, Meng-Zhi Pan1, Lu-Long Bo3#, and Hong-Wei Duan1#

From 1Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China; 2Department of Respiratory Medicine, NO. 101 Hospital of PLA, Wuxi, China; 3Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China.

*Bao-Ji Hu, Jian Xu, Xiao-Hong Zhao contributed equally to the article.

#Both Lu-Long Bo and Hong-Wei Duan are corresponding authors.

Correspondence to Dr. Lu-Long Bo at nbastars@126.com or Dr. Hong-Wei Duan at duanhongwei120@126.com.

EBCMED ID: ebcmed.japm.2016.0022 DOI: 10.24015/ebcmed.japm.2016.0022


Endotracheal tube (ETT) is often necessary to achieve airway control during general anesthesia. Recent studies have showed that sore throat following endotracheal intubation is a common complaint after surgery. The objective of this systematic review and meta-analysis was to estimate whether ETT cuff pressure affects the incidence of postoperative sore throat (POST) after general anesthesia.

The following databases were searched electronically: PubMed (updated to Nov 2015), EMBASE (updated to Nov 2015), World Health Organization International Clinical Trials Registry Platform (updated to Jul 2015), Chinese BioMedical Literature Database (1978 to Oct 2015), and China National Knowledge Infrastructure (1994 to Oct 2015). Trials comparing EET cuff pressure for elective surgery were included.

Three trials with a total of 609 patients were included in current analysis. Pool results from these trials showed that a lower ETT cuff pressure significantly decreased the incidence of POST at 24 hours after surgery (relative ratio [RR]=0.76, 95% confidence interval [CI] 0.61-0.95, P<0.05). However, there wasn't any difference between lower and higher cuff pressure on the incidence of POST in post-anesthesia care unit (PACU) (RR=1.00, 95% CI 0.31-3.25, P=1). A lower ETT cuff pressure was not associated with a lower incidence of postoperative hoarseness (PH) at 24 hours after surgery (RR=0.71, 95% CI 0.26- 1.92, P=0.50) and in PACU (RR=1.07, 95% CI 0.59-1.93, P=0.82).

Our meta-analysis suggested that lower ETT cuff pressure was associated with a lower incidence of POST in patients undergoing general anesthesia at 24 hours after surgery. However, the exact effect of ETT cuff pressure on patients undergoing general anesthesia deserves further studies.

Article Type
Systematic Review and Meta-Analysis

Declaration of Interests
All authors declare there were no conflict of interest in the work.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.