Comparison of Two Methods for Inflating the Cuff of the Breathing Tube During General Anaesthesia in operation theatre

INTERVENTION: Intervention1: Group A Manometer guided cuff pressure technique: Following successful endotracheal intubation the ETT cuff will be inflated using a calibrated cuff pressure manometer to a target pressure of 0‐30cm h20. The cuff pressure will be confirmed by direct manometry and recorded. Intervention2: Group B Minimal leak test technique: Following successful endotracheal intubation, the ETT cuff will be inflated until no audible leak is heard during positive pressure ventilation. Air will then be slowly withdrawn in 0.1ml until minimal audible leak is detectable at peak inspiration. The final achieved cuff pressure will then be measured using a calibrated manometer and recorded. Intervention3: Nil: Nil CONDITION: Health Condition 1: R098‐ Other specified symptoms and signsinvolving the circulatory and respiratory systems PRIMARY OUTCOME: To compare endotracheal tube cuff pressure cm H20 achieved by manometer guided cuff inflation versus the minimal leak test immediately after intubationTimepoint: Immediately after endotracheal intubation, T0 SECONDARY OUTCOME: To compare haemodynamic parameters at pre‐induction, post induction,5mins, 20min, 25min between the two groups. ; Timepoint: to assess post‐intubation airway complications at 1hour & 24hours post‐extubation INCLUSION CRITERIA: ASA physical status 1,2 or 3 Age 18 to 65 years Elective surgical procedures requiring general anaesthesia with endotracheal intubation Anticipated intubation duration of at least 30 minutes Willing to give written informed consent and able to communicate effectively