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Effects of Tracheal Intubation on Laryngeal Acoustic Waveforms

Departments of Anesthesia, the University Hospital, Basel, Switzerland, and Harvard Medical School at the Charles A. Dana Research Foundation, Beth Israel Hospital, Boston, Massachusetts, and The Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.

Abstract

To assess the feasibility of noninvasive detection of laryngeal injury after trached intubation through acoustic waveform measurements, we studied the effects of intubation on "time-expanded" acoustic waveforms of the larynx in 16 patients given general anesthesia, 9 with and 7 without tracheal intubation. Recordings of several utterances were obtained by means of a microphone and an accelerometer attached to the skin at the midpoint of the suprasternal notch. Recordings were taken the day before induction of general anesthesia, 20 minutes after extubation, and 2 and 4 days after extubation. Waveforms of the recordings were subsequently assessed visually for features different fromthose of normal phonation as determined in preliminary studies. Waveforms in several ofthe recordings taken soon after extubation showed marked intraperiod and interperiod irregularities. These abnormalities improved and disappeared over the following 4 days. No changes were observed in the acoustic waveforms of seven patients given general anesthesia without tracheal intubation. The analysis of time-expanded acoustic waveforms of the larynx indicates that this technique has considerable potential as a sensitive, noninvasive technique that helps to evaluate the effects of tracheal intubation on laryngeal function, a technique that warrants further study and evaluation.

Key Words: INTUBATION, TRACHEAL—complications • LARYNX, FUNCTION—postoperative

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999