Irrigation Fluid Volume, Tube Cuff Pressure, and Neck Swelling During Shoulder Arthroscopy

During shoulder arthroscopy, fluid is pumped into the shoulder to help the surgeon see inside the joint. Some of this fluid can move into the tissues around the shoulder and neck and cause swelling. During general anesthesia, a breathing tube is placed in the windpipe. This tube has a small inflatable balloon, called a cuff, whose pressure may increase when the surrounding tissues swell. The purpose of this study is to determine whether larger amounts of irrigation fluid used during shoulder arthroscopy are associated with greater increases in breathing tube cuff pressure and neck soft tissue thickness. About 60 adults undergoing planned shoulder arthroscopy in the beach-chair position will take part. The study will not change the participants' anesthesia, surgery, or treatment. Researchers will record the amount of irrigation fluid used, measure cuff pressure at set times during surgery, and measure the neck before and after surgery using ultrasound and a measuring tape. Sore throat, hoarseness, and other airway symptoms will be assessed after surgery. Participants will be followed until six hours after surgery.

Inclusion Criteria: * Age 18 to 75 years * American Society of Anesthesiologists physical status I-III * Scheduled for elective shoulder arthroscopy in the beach-chair position under general anesthesia with orotracheal intubation * Able to read and understand Turkish and provide written informed consent Exclusion Criteria: * Emergency surgery * Pregnancy * Preoperative hoarseness, sore throat, or dysphagia * Upper respiratory tract infection within the previous 2 weeks * Tracheostomy, known laryngeal or tracheal disease, or previous major neck surgery or radiotherapy * Anticipated difficult airway, defined as Mallampati class III-IV or difficult airway predicted by the attending anesthesiologist * More than two tracheal intubation attempts or traumatic intubation * Surgery performed in the lateral decubitus position * Intraoperative use of nitrous oxide * Inability to obtain reliable ultrasonographic measurements