Key result
Brandt tubes delay cuff pressure return by ~40 minutes vs control and reduce 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 control tube?
Does the Brandt™ tube system prevent cuff deflation and air leaks after cessation of nitrous oxide anesthesia compared to a control 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 whether findings warrant routine adoption over standard tubes.
The Brandt™ tube system can limit excessive cuff pressure during nitrous oxide (N2O) anesthesia, but there is a lack of data assessing whether the Brandt™ tube system avoids cuff deflation after cessation of N2O 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% N2O anesthesia and the cuffs were aspirated if the cuff pressure exceeded 22 mm Hg; 180 min later, O2 was substituted for N2O. The cuff pressure of both groups significantly decreased after N2O 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 N2O 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 N2O anesthesia, whereas repeated cuff deflation during N2O anesthesia causes cuff deflation after cessation of N2O, resulting in a possible risk of air leaks.
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Karasawa et al. (2003) studied Nitrous oxide (N2O) anesthesia. Brandt™ tube system vs. Hi-Contour™ tracheal tubes was evaluated on Time required for the cuff pressure to return to the initial pressure (p=0.03). The Brandt™ tube system prolonged the time for cuff pressure to return to initial pressure compared to control (76.5 vs 36.5 min; P=0.03) and reduced the incidence of air leaks (P=0.015).
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