A prospective randomized observational study to compare the tracheal cuff inflation method guided by pressure volume loop closure versus manometer in a supine position.

Cuffed endotracheal tube is widely used for general anesthesia and is popularly known to maintain adequate sealing of airway against  gastro-pharyngeal aspiration along with adequate lung ventilation. It provides better seal for trachea. Pressure inside the cuff should be adequate enough to seal the trachea against but simultaneously care should be taken that the pressure should not be too high to cause harmful effects on trachea with pressure changes such as tracheal ischemia, nerve palsies, or post op complications such as sore throat, hoarsness or dysphagia. Hence, as a researcher our aim should be to find out the best method to measure the volume of air that is required to inflate the cuff.  Although manometer is considered as the gold standard and it is said that the pressure should be around 20-30 cm of h20 in manometer to achieve adequate sealing of cuff, it might not be available in every periphery or limited resources places. Hence the goal is to compare the amount of volume required to inflate the cuff by pressure volume loop closure method and manometer and to compare the post operative complications such as hoarsness and sorethroat.