Ease of laryngeal passage during fibreoptic intubation: a comparison of three endotracheal tubes

Acta Anaesthesiologica Scandinavica
K F BarkerP A Coe

Abstract

The use of a fibreoptic bronchoscope to facilitate endotracheal intubation is well established in modern anaesthetic practice. Difficulty may be encountered when inserting an endotracheal tube over the fibrescope as the bevelled tip can impinge on the vocal cords or epiglottis and impede advancement through the laryngeal inlet. Intavent have recently developed a tapered tip tube for use with their Intubating Laryngeal Mask Airway. A randomised, double-blind study was performed to compare the ease of railroading three different tubes over a fibrescope placed in the trachea. We studied 54 patients presenting for elective dental surgery. General anaesthesia was induced with propofol 2-3 mg/kg, fentanyl 1-1.5 microg/kg, and atracurium 0.5 mg/kg and maintained with oxygen (5 l/min) and isoflurane 1-2%. Nasotracheal fibreoptic intubation was attempted in all patients. In each case the ease of tube advancement over the fibrescope and into the trachea was evaluated by the blinded observer, using the classification system (Grade 0-2) described by Jones et al. The Intavent tube was found to be superior for nasotracheal fibreoptic intubation to either the Mallinckrodt reinforced tube (P<0.034) or the Portex Blue Line tube (P<0.004).

References

May 1, 1983·Canadian Anaesthetists' Society Journal·S R Mallampati
Apr 1, 1994·Anesthesia and Analgesia·S J BrullD G Silverman
Aug 1, 1993·Anaesthesia·H E JonesP Moore

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Citations

Jun 18, 2004·Anaesthesia·J J HendersonUNKNOWN Difficult Airway Society
Jun 6, 2009·Acta Anaesthesiologica Scandinavica·K SugiyamaA Kohjitani
Nov 9, 2006·Anaesthesia·A J Shearer, B E McGuire
Nov 12, 2015·British Journal of Anaesthesia·C FrerkUNKNOWN Difficult Airway Society intubation guidelines working group
Mar 8, 2011·Anaesthesia and Intensive Care·P A BakerUNKNOWN Australian and New Zealand College of Anaesthetists

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