Exploration of tracheal tube contact pressure and simplified risk indicators for postoperative laryngopharyngeal discomfort: a prospective pilot study.

Authors

Li Fang Wang, Nan Liang, Meng Tao Zheng, Hao Ning Ma, Jiang Shan Huang, Guo Hui Fan, Jing Zhao, Wei Xia Li

Published in

Anaesthesiology intensive therapy. Volume 58. Issue 1. Pages 127-136. Jun 19, 2026.

Abstract

Postoperative laryngopharyngeal discomfort (POLPD) is a common yet undermanaged complication after tracheal extubation. While mechanical pressure from the endotracheal tube is implicated, quantitative data linking tube-tissue contact pressure to POLPD are lacking. This study aimed to establish a quantitative relationship between tracheal tube contact pressure and POLPD, while identifying bedside applicable, simplified clinical risk indicators.
In this prospective observational study, 89 patients undergoing elective surgery (≥ 2 hours) were enrolled. We adapted a T-scan III occlusal analysis system to measure tracheal tube pressure distribution at four intraoperative timepoints. POLPD was defined as a composite endpoint including severe pharyngalgia (NRS ≥ 4), profound dysphagia (bedside water swallow test ≥ 4), or prominent tongue edema.
POLPD incidence was 39.1%. Multivariate analysis identified two independent risk profiles: female with narrow pharyngeal cavity (OR 3.26, 95% CI: 2.1-4.87, P < 0.001) and prone position with non-neutral O-C2 angle (OR 1.94, 95% CI: 1.34-2.81, P < 0.001). The POLPD group had significantly higher tracheal tube pressures. A pressure-overload index independently predicted POLPD (OR 1.17, 95% CI: 1.01-1.37, P = 0.041), demonstrating a dose-response relationship.
This study provides quantitative evidence linking tracheal tube contact pressure to POLPD. Two simplified clinical risk indicators were identified: "lady overweight, chin looks short, snore at night, airway's tight" (female with narrow pharyngeal cavity) and "neck bent too far" (prone with non-neutral O-C2 angle). Real-time pressure monitoring is a promising target for future airway protection.

PMID:
42417175
Bibliographic data and abstract were imported from PubMed on 08 Jul 2026.

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