Background: Positional change affects the cuff pressure of endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of TaperGuard ETT and cylindrical ETT after lateral rotation of head during middle ear surgery.
Methods: Fifty two patients aged 18-70 years underwent tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (Group C, n=26) or TaperGuard ETT (Group T, n=26). After endotracheal intubation, ETT cuff pressure was set at 22 cmH2O in the neutral position of head. After lateral rotation of head the cuff pressure was measured again and readjusted to 22 cmH2O. In addition, the change of distance from the carina to the tip of ETT was measured before and after positional change. The incidence of cough, sore throat, and hoarseness was assessed at 30 min, 6 hr, and 24 hr after surgery.
Results: There was no difference in demographic data between groups. After lateral rotation of head, cuff pressure significantly increased in group T (11.9 ± 2.3 cmH2O), compared with group C (6.0 ± 1.9 cmH2O) (P < 0.001). The incidence of cuff pressure more than 30 cmH2O was higher in group T (96.2%) than in group C (30.8%) (P < 0.001). In addition, the degree of displacement of ETT was greater in group T (11.0 ± 1.7 mm) than in group C (7.2 ± 2.6 mm) (P < 0.001). The overall incidences of postoperative sore throat, hoarseness, and cough at 30 min, 6 h, and 24 h after surgery were comparable between two groups.
Conclusion: The cuff pressure was higher in TaperGuard ETT than in cylindrical ETT after positional change of head from neutral to lateral rotation. In addition, after postional change the extent of displacement of ETT was greater in TaperGuard ETT than in cylindrical ETT.

Comparison of the intracuff pressure of tapered-cuff endotracheal tube and classic cylindrical-cuff endotracheal tube after lateral rotation of head during middle ear surgery: a prospective, single-blind randomized, controlled trial