Observational studyAnaesthesiology intensive therapy2026
Exploration of tracheal tube contact pressure and simplified risk indicators for postoperative laryngopharyngeal discomfort: a prospective pilot study.
Observational study in Anaesthesiology intensive therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundPostoperative laryngopharyngeal discomfort (POLPD) is a common yet undermanaged complication after tracheal extubation. While mechanical pressure from the endotracheal tube is implicated, quantitative data linking tube-tissue contact pressure to POLPD are lacking. This study aimed to establish a quantitative relationship between tracheal tube contact pressure and POLPD, while identifying bedside applicable, simplified clinical risk indicators.
methodsIn this prospective observational study, 89 patients undergoing elective surgery (≥ 2 hours) were enrolled. We adapted a T-scan III occlusal analysis system to measure tracheal tube pressure distribution at four intraoperative timepoints. POLPD was defined as a composite endpoint including severe pharyngalgia (NRS ≥ 4), profound dysphagia (bedside water swallow test ≥ 4), or prominent tongue edema.
resultsPOLPD incidence was 39.1%. Multivariate analysis identified two independent risk profiles: female with narrow pharyngeal cavity (OR 3.26, 95% CI: 2.1-4.87, P < 0.001) and prone position with non-neutral O-C2 angle (OR 1.94, 95% CI: 1.34-2.81, P < 0.001). The POLPD group had significantly higher tracheal tube pressures. A pressure-overload index independently predicted POLPD (OR 1.17, 95% CI: 1.01-1.37, P = 0.041), demonstrating a dose-response relationship.
conclusionsThis study provides quantitative evidence linking tracheal tube contact pressure to POLPD. Two simplified clinical risk indicators were identified: "lady overweight, chin looks short, snore at night, airway's tight" (female with narrow pharyngeal cavity) and "neck bent too far" (prone with non-neutral O-C2 angle). Real-time pressure monitoring is a promising target for future airway protection.
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