KNOWLEDGE AND PRACTICE OF INTRAOPERATIVE MANAGEMENT OF ENDOTRACHEAL TUBE CUFF PRESSURE

Abstract

Background: Endotracheal tube (ETT) cuff pressure management is essential for maintaining airway safety during general anesthesia. Incorrect cuff pressure can lead to serious complications such as tracheal mucosal injury, aspiration, postoperative sore throat, and ventilator-associated pneumonia. Despite clear guidelines recommending objective cuff pressure monitoring, many clinicians still rely on subjective methods. Assessing existing knowledge and practice patterns is vital for improving patient outcomes. Objective: To evaluate the knowledge, attitude, and practice of anesthetists regarding intraoperative management of endotracheal tube cuff pressure in a tertiary care setting. Material and Methods: A cross-sectional study was conducted over three months among 65 anesthetists at SIUT. Data were collected using a structured, self-administered questionnaire covering demographics, knowledge, attitude, and practice domains. Responses were analyzed using SPSS version 24. Descriptive statistics were expressed as means, standard deviations, frequencies, and percentages. Results: Most participants demonstrated good knowledge: 75.4% correctly identified the recommended cuff pressure, and 78.5% recognized the manometer as the gold standard. Attitudes were largely positive, with 76.9% strongly agreeing that correct cuff pressure improves patient safety. However, practical adherence was limited—only 38.5% had ever used a manometer and 70.8% reported unavailability in their centers. Subjective methods such as pilot balloon palpation (46.2%) remained the most common practice. Conclusion: Although anesthetists showed strong theoretical knowledge and positive attitudes toward ETT cuff pressure monitoring, actual clinical practice was inadequate, largely due to limited availability of manometers and reliance on subjective techniques. Improving access to monitoring devices and enhancing practical training may strengthen patient safety and reduce cuff-related complications.