Ease of laryngeal passage during fibreoptic intubation: a comparison of three
endotracheal tubes.
Author(s): Barker KF, Bolton P, Cole S, Coe PA.
Affiliation(s): Department of Anaesthesia, Highland Acute Hospitals NHS Trust, Inverness,
Scotland. kennethbarker@hotmail.com
Publication date & source: 2001, Acta Anaesthesiol Scand. , 45(5):624-6
BACKGROUND: 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.
METHODS: 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.
RESULTS/CONCLUSION: 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).
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