Key result
Brandt tracheal tube prolongs cuff pressure return by ~40 minutes vs control and reduces air leaks.
Why the study?
There was a lack of data assessing whether the Brandt tube system avoids cuff deflation after cessation of nitrous oxide anesthesia.
Does the Brandt tube system prevent cuff deflation and air leaks after cessation of nitrous oxide anesthesia compared to a standard tracheal tube?
Does the Brandt tube system prevent cuff deflation and air leaks after cessation of nitrous oxide anesthesia compared to a standard tracheal tube?
Absolute Event Rate: 76.5% vs 36.5%
p-value: p=0.03
The Brandt tube system attenuates the cuff deflationary phenomenon and reduces the risk of air leaks after cessation of nitrous oxide anesthesia.
May reduce post-N2O air-leak risk with Brandt tubes; leaves open confirmation in larger trials before practice change.
The Brandt tube system can limit excessive cuff pressure during nitrous oxide (N(2)O) anesthesia, but there is a lack of data assessing whether the Brandt tube system avoids cuff deflation after cessation of N(2)O administration. In this study, we recorded air-filled cuff pressures of the Mallinckrodt Brandt or Hi-Contour (control) tracheal tubes (Mallinckrodt, Athlone, Ireland) during 67% N(2)O anesthesia and the cuffs were aspirated if the cuff pressure exceeded 22 mm Hg; 180 min later, O(2) was substituted for N(2)O. The cuff pressure of both groups significantly decreased after N(2)O anesthesia but the time required for the cuff pressure to return to the initial pressure was longer in the Brandt group than in the control group (76.5 +/- 35.2 min and 36.5 +/- 18.1 min, respectively; P = 0.03). The incidence of air leaks was more frequent in the control group than in the Brandt group (P = 0.015); changes in intracuff N(2)O were small in the Brandt group (6.6 +/- 1.2% to 3.4 +/- 0.9%) compared with those in the control group (46.2 +/- 3.8% to 18.6 +/- 5.6%). Therefore, the Brandt tube system attenuates the cuff deflationary phenomenon after N(2)O anesthesia, whereas repeated cuff deflation during N(2)O anesthesia causes cuff deflation after cessation of N(2)O, resulting in a possible risk of air leaks.
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Karasawa et al. (2003) studied Nitrous oxide (N2O) anesthesia. Mallinckrodt Brandt tracheal tube vs. Hi-Contour (control) tracheal tube was evaluated on Time required for the cuff pressure to return to the initial pressure (p=0.03). The Brandt tracheal tube significantly prolonged the time for cuff pressure to return to baseline after N2O anesthesia compared to control (76.5 vs 36.5 min; P=0.03) and reduced air leaks (P=0.015).
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