Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942004000300007
Brazilian Journal of Anesthesiology
Scientific Article

Determinação de volumes e pressões de balonetes de tubos traqueais insuflados com ar ambiente ou óxido nitroso

Volume and pressure of tracheal tube cuffs filled with air or nitrous oxide

Ernesto Leonardo Cárpio Peña; Waldemar Montoya de Gregori; Luiz Piccinini Filho; Joaquim Edson Vieira; Lígia Andrade da Silva Telles Mathias

http://dx.doi.org/10.1590/S0034-70942004000300007 Braz J Anesthesiol, vol.54, n3, p.335-342, 2004
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Resumo

JUSTIFICATIVA E OBJETIVOS: A pressão exercida pelo balonete do tubo traqueal contra a parede da traquéia deve permitir fluxo capilar adequado e prevenir escapes de ar ou aspiração pulmonar. Esta pesquisa procurou determinar as variações de pressão do balonete insuflado com ar ambiente ou com óxido nitroso a 100%. MÉTODO: Trinta pacientes foram selecionados para receber anestesia geral balanceada com intubação orotraqueal. O balonete foi insuflado conforme critérios clínicos. As medidas de base foram realizadas após 15 minutos do início da anestesia com um manômetro aneróide calibrado em cm de H2O e forneceram os valores iniciais de pressão e volume. Os pacientes foram divididos em dois grupos: balonete reinsuflado com ar ambiente, grupo A, ou com óxido nitroso, grupo B. As medidas de pressão foram obtidas em intervalos até a primeira hora e os resultados comparados. RESULTADOS: Os grupos mostraram-se comparáveis para idade e sexo. Em ambos os grupos os valores basais médios para pressão foram próximos de 40 cmH2O com 8 ml de volume. No grupo com ar ambiente, as pressões aumentaram até 36 cmH2O em uma hora. No grupo de balonete insuflado com N2O, as pressões diminuíram abaixo de 20 cmH2O entre 20 e 30 minutos de anestesia. CONCLUSÕES: O uso de N2O a 100% para insuflação do balonete de sonda traqueal não constitui método seguro, acarretando progressiva perda da capacidade de vedação. O uso de ar ambiente promove aumento de volume e de pressão no balonete, aumentando possibilidade de lesão da mucosa traqueal.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, EQUIPAMENTOS, INTUBAÇÃO TRAQUEAL, TÉCNICAS DE MEDIÇÃO

Abstract

BACKGROUND AND OBJECTIVES: Tracheal tube cuff pressure against tracheal wall should to prevent air leaked or pulmonary aspiration, allowing adequate capillary blood flow. This study aimed at determining pressure variations of tracheal tube cuffs filled with air or 100% nitrous oxide. METHODS: Participated in this study 30 patients submitted to balanced general anesthesia with tracheal intubation. Cuff was inflated according to clinical criteria. The intracuff pressure measurements were undertaken after 15 minutes of anesthesia by means of an aneroid manometer gaged in cm of H2O and have provided initial pressure and volume values. The patients was allocated in two groups: cuff inflated with air, group A, and with nitrous oxide, group B. Measurements were recorded during one hour and results were compared. Groups were homogeneous in gender and age. RESULTS: Both groups have shown baseline pressure values close to 40 cmH2O with 8 ml of volume. Group filled with air had pressures increased up to 36 cmH2O in one hour. Group filled with nitrous oxide had pressures decreased below 20 cmH2O after 20 to 30 minutes of anesthesia. CONCLUSIONS: 100% nitrous oxide to fill tracheal tube cuffs is not a safe method resulting in progressive air leakage. The cuff air promotes volume and pressure increase, with higher chances for tracheal mucosa injury.

Keywords

ANESTHETICS, ANESTHETICS, EQUIPMENTS, MEASUREMENT TECHNIQUES, TRACHEAL INTUBATION

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