2022 Volume 50 Issue 3 Pages 122-124
Cuff damage in endotracheal tubes causes a variety of complications because of the reduction in cuff pressure. This report describes a case in which an automatic cuff pressure controller (SmartCuff® ; Murata Manufacturing Co., Kyoto, Japan) enabled the early detection of cuff damage. A 23-year-old woman underwent a maxillary osteotomy and sagittal split ramus osteotomy under general anesthesia. After rapid induction, the tracheal tube was intubated through the right nostril. The tracheal tube was difficult to guide into the glottis, and Magill forceps were required to introduce the tracheal tube. The anesthesiologist confirmed the absence of leaks in the cuff and the absence of any abnormalities in the capnogram waveform, bilateral lung sounds, or tidal volume. After several minutes, the anesthesiologist started monitoring the cuff pressure using the SmartCuff® and noticed an alarm. As damage to the cuff was suspected, we considered that reintubation was necessary. A laceration on the cuff of the extubated tube was detected near the tip. The SmartCuff® is a useful device for cuff pressure management during tracheal intubation because an alarm will quickly sound if any decrease in cuff air pressure is detected. Cuff air leaks can result in a decrease in the ventilation volume, abnormalities in the capnogram waveform, and leak-related sounds. In the present case, the cuff damage activated the alarm of the SmartCuff® despite the absence of abnormal anesthetic monitoring findings. Therefore, the tracheal tube could be replaced before starting surgery, and the anesthesia was managed safely.
