Abstract：
The cuff pressure of a tracheal tube may increase during robot-assisted laparoscopic surgery for prostatectomy (RALP), which requires pneumoperitoneum in a steep head-down position, but there have been no studies which confirmed this.
In study 1, we studied how frequently the cuff pressure significantly increased during anesthesia for the RALP. In study 2, we studied if the SmartCuff (Smiths Medical Japan, Tokyo) automatic cuff pressure controller would minimize the changes in the intracuff pressure. With approval of the study by the research ethics committee (approved number: 20115), we measured the cuff pressures in anesthetized patients undergoing RALP and in those undergoing gynecological laparotomy (as a reference cohort), with and without the use of the SmartCuff.
In 21 patients undergoing RALP, a clinically meaningful increase (5 cmH2O or greater) was observed in all the 21 patients (P = 0.00; 95% CI for difference: 86-100%), whereas in 23 patients undergoing gynecological laparotomy, a clinically meaningful decrease (5 cmH2O or greater) was observed in 21 of 23 patients (91%, P < 0.0001; 95% CI for difference: 72-99%). With the use of the SmartCuff, there was no significant increase in the incidence of a clinically meaningful change in the intracuff pressure in either cohort.
The cuff pressure of a tracheal tube would frequently increase markedly in patients undergoing RALP, whereas it would frequently decrease markedly in patients undergoing gynecological laparotomy. The SmartCuff may inhibit the changes in the cuff pressure during anesthesia.
In study 1, we studied how frequently the cuff pressure significantly increased during anesthesia for the RALP. In study 2, we studied if the SmartCuff (Smiths Medical Japan, Tokyo) automatic cuff pressure controller would minimize the changes in the intracuff pressure. With approval of the study by the research ethics committee (approved number: 20115), we measured the cuff pressures in anesthetized patients undergoing RALP and in those undergoing gynecological laparotomy (as a reference cohort), with and without the use of the SmartCuff.
In 21 patients undergoing RALP, a clinically meaningful increase (5 cmH2O or greater) was observed in all the 21 patients (P = 0.00; 95% CI for difference: 86-100%), whereas in 23 patients undergoing gynecological laparotomy, a clinically meaningful decrease (5 cmH2O or greater) was observed in 21 of 23 patients (91%, P < 0.0001; 95% CI for difference: 72-99%). With the use of the SmartCuff, there was no significant increase in the incidence of a clinically meaningful change in the intracuff pressure in either cohort.
The cuff pressure of a tracheal tube would frequently increase markedly in patients undergoing RALP, whereas it would frequently decrease markedly in patients undergoing gynecological laparotomy. The SmartCuff may inhibit the changes in the cuff pressure during anesthesia.
摘要：
目的：在机器人辅助腹腔镜前列腺切除术（RALP）期间，气管导管的袖带压力可能会增加，这需要气腹处于陡峭的头部向下的位置，但是没有研究证实这一点。
方法：在研究1中，我们研究了RALP麻醉期间袖带压力显着增加的频率。在研究2中，我们研究了SmartCuff(SmithsMedicalJapan，东京）自动袖带压力控制器将最大程度地减少内部压力的变化。经研究伦理委员会批准（批准编号：20115），我们测量了接受RALP的麻醉患者和接受妇科剖腹手术的患者的袖带压力（作为参考队列），使用和不使用SmartCuff。
结果：在接受RALP的21例患者中，在所有21例患者中观察到有临床意义的增加（5cmH2O或更大）（P=0.00;差异的95％CI：86-100％），而在23例妇科剖腹手术患者中，23例患者中有21例(91%，P<0.0001；差异95%CI：72-99%）。随着SmartCuff的使用,在这两个队列中,有临床意义的腔内压变化的发生率均无显著增加.
结论：在接受RALP的患者中，气管导管的袖带压力通常会明显增加，而在接受妇科剖腹手术的患者中，它通常会显着降低。SmartCuff可以抑制麻醉期间袖带压力的变化。
方法：在研究1中，我们研究了RALP麻醉期间袖带压力显着增加的频率。在研究2中，我们研究了SmartCuff(SmithsMedicalJapan，东京）自动袖带压力控制器将最大程度地减少内部压力的变化。经研究伦理委员会批准（批准编号：20115），我们测量了接受RALP的麻醉患者和接受妇科剖腹手术的患者的袖带压力（作为参考队列），使用和不使用SmartCuff。
结果：在接受RALP的21例患者中，在所有21例患者中观察到有临床意义的增加（5cmH2O或更大）（P=0.00;差异的95％CI：86-100％），而在23例妇科剖腹手术患者中，23例患者中有21例(91%，P<0.0001；差异95%CI：72-99%）。随着SmartCuff的使用,在这两个队列中,有临床意义的腔内压变化的发生率均无显著增加.
结论：在接受RALP的患者中，气管导管的袖带压力通常会明显增加，而在接受妇科剖腹手术的患者中，它通常会显着降低。SmartCuff可以抑制麻醉期间袖带压力的变化。
