Effect of Placing the Endotracheal Tube Beyond Cervical C7 Level in Anterior Cervical Decompression and Fusion Surgery: An Observational Study On Endotracheal Cuff Pressure Changes
Conditions: Anterior Spinal Artery Compression Syndromes, Cervical Region
Sponsor: Universiti Kebangsaan Malaysia Medical Centre

 
 
 
 
EFFECT OF PLACING THE ENDOTRACHEAL TUBE BEYOND CERVICAL C7 
LEVEL IN ANTERIOR CERVICAL DECOMPRESSION AND FUSION SURGERY: 
AN OBSERVATIONAL STUDY ON ENDOTRACHEAL CUFF PRESSURE 
CHANGES 
 
 
 
 
 
Dr. Liu Chian Yong MD (UKM), MMED Anaesthesiology (UKM) 
 
Dr. Noor Afifah binti Said (Alexandria University, Egypt ) 
 
 
 
 
 
 
UNIVERSITI KEBANGSAAN MALAYSIA (UKM) 
2024 
 
 
18th June

 
2
FLOWCHART 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exclusion criteria:  
1. Patients who is already ventilated 
prior to ACDF surgery 
2. Anatomical deformity in the neck 
3. Pre-existing sore throat, dysphagia, 
hoarseness of voice 
Inclusion criteria: 
1. ACDF surgery 
2. Age between 18-80 years  
3. ASA I, II or III 
 
All patient posted for ACDF. 
• Intubation and placement of endotracheal cuff beyond C7. 
• Inflate the ETT cuff to 20 cmH20 and check for equal breath sound. 
• Visualisation of carina using flexible fibreoptic scope. 
• Reconfirmation of ETT placement using image-intensifier. 
• Continuous monitoring of ETCP by connecting pilot balloon to the pressure transducer 
Written informed consent taken. 
• Primary objectives: Monitoring of pressure variation every 15 min. and 
record these ETCP 
1. ETCPbase  which is the baseline pressure after neck extension  
2. ETCPbefore before retraction of neck tissues  
3. ETCPretract during retraction of neck tissues 
4. ETCPafter after the removal of retractors 
• Secondary objectives : 
1. Assess sore throat, dysphagia, and hoarseness of voice in recovery, 
6 hours, and 24 hours after extubation.