Abstract

Monitoring cuff pressure is important as it helps avoid tracheal morbidity. The effects of prolonged cuff inflation with high pressures are well discussed in the literature.¹ In particular, during general anesthesia requiring nitrous oxide, the cuff volume of the inflated air is increased because diffusion of nitrous oxide into the cuff leads to an increase in cuff pressure.²

A cuff pressure monitor, although available commercially, is not universally available. I use a modified cuff inflator/monitor for cuff pressure monitoring using a three-way stopcock, sphygmomanometer inflating bulb and pressure tubing (Figure 1). This assembly gives a continuous cuff reading during cuff inflation and deflation.

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Figure 1 Modified cuff pressure monitor assembly.

A pressure module/transducer assembly used for invasive or direct pressure monitoring can also be used to monitor the cuff pressure continuously. It not only gives a numerical value but also a continuous tracing. The port for flushing the pressure tubing is used for inflation/deflation of the cuff to acceptable and safe limits. I found it useful in laryngeal surgeries where there can be a risk of cuff rupture or leakage, as this is immediately reflected in an exceptional reading, and pressure can be continuously traced as well.

Thus, a modified cuff pressure monitor to control cuff inflation/deflation may prove useful to avoid tracheal morbidity.