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"Effect of Tracheal Intubation Mode on Cuff Pressure During Retractor Splay and Dysphonia Recovery after for Anterior Cervical Spine Surgery: A Randomized Clinical Trial" by Huang et al.

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1. Were all patients operated by the same surgeon? Did all team members have same level of surgical experience? It would add value to the results as whether it affected… Click to show full abstract

1. Were all patients operated by the same surgeon? Did all team members have same level of surgical experience? It would add value to the results as whether it affected the incidence of complications or not. 2. The authors mention that the surgical durations were longer in the nasotracheal intubation group. How do the authors explain this finding? Or was it simply because they added the time taken to intubate to the surgical duration? Did surgical duration affect the rate of dysphonia? 3. The authors mention that after maximal endotracheal tube cuff pressure (ETCP) was recorded it was then maintained at <25 mmHg to eliminate possible affect of pressure so that modes of intubation can be compared. How do we account for the fact that the two intubation modes might differ and lead to differential complication rate because of inherent differences in ETCP itself and not just the axis of the tube? 4. The authors mention that among patients receiving <7 size orointubation had higher dysphonia scores when compared to nasointubation group. What in the authors’ opinion is the reason for this finding to be size-specific rather than the whole group? 5. It would add immense value if we were to know how many of the total patients having dysphonia required treatment and of what type? Whether any of these patients received methylprednisolone perioperatively or later and how it affected the incidence or recovery thereof.

Keywords: cuff pressure; recovery; intubation; dysphonia

Journal Title: Spine
Year Published: 2020

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