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


CONCLUSIONS
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).
Barker
K F
KF
Department of Anaesthesia, Highland Acute Hospitals NHS Trust, Inverness, Scotland. kennethbarker@hotmail.com
Bolton
P
P
Cole
S
S
Coe
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks; D007830:Larynx / Q000502:physiology*; D008297:Male; D008875:Middle Aged