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. 2025 May 18;17(5):e84376.
doi: 10.7759/cureus.84376. eCollection 2025 May.

Comparison of the Efficacy of Throat Pack in Uncuffed Tube Versus Microcuff® Tubes on Sealing Pressure in Pediatric Laparoscopic Surgeries: A Randomized Clinical Trial

Roushan Patel  1   2 , Rishi Anand  1   2 , Deb Sanjay Nag  1 , Biswajit Sen  1 , Roshan Lal Gope  1   2 , Tapas Barman  1   2
Affiliations

Comparison of the Efficacy of Throat Pack in Uncuffed Tube Versus Microcuff® Tubes on Sealing Pressure in Pediatric Laparoscopic Surgeries: A Randomized Clinical Trial

Roushan Patel et al. Cureus. .

Abstract

Background and aims Pneumoperitoneum and extreme Trendelenburg position in laparoscopic surgeries require ventilation at higher peak pressure, potentially resulting in peritubular leak and difficult ventilation. Our study aimed to assess whether a throat pack can provide an adequate seal to prevent peritubular leak around uncuffed tube pediatric laparoscopic surgeries as compared to a Microcuff® tube. Methods This randomized clinical trial was carried out on 94 children aged between eight months and five years undergoing laparoscopic surgery under general anesthesia allocated in two parallel groups using a computer-generated random number. We compared sealing pressure, peritubular leak, adequacy of ventilation, quality of capnography, and post-extubation laryngospasm or stridor. Results The uncuffed tube with a throat pack effectively seals the airway, and neither the creation of pneumoperitoneum nor the Trendelenburg position affected ventilation or the seal's effectiveness. There was no significant difference in the incidence of postoperative stridor between the two groups. Conclusion The throat pack provides an effective seal in an uncuffed tube to perform laparoscopic surgery without increasing airway morbidity.

Keywords: anesthesia; artificial endotracheal intubation throat pack airway management; cuffed; endotracheal; endotracheal tubes; general; laparoscopy; pediatric surgery; tube; ventilation.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institute Ethics Committee of the Jawaharlal Institute of Postgraduate Medical Education and Research issued approval JIP/IEC/2016/27/918. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CONSORT flow diagram
CONSORT: Consolidated Standards of Reporting Trials
See this image and copyright information in PMC

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