The effects of tracheal tube tip design and tube thickness on laryngeal pass ability during oral tube exchange with an introducer.
We compared the ease of passage through the glottis of two different tubes and two different sizes of tracheal tube exchanger (TE) during introducer-guided tracheal intubation. One tube was a polyvinyl chloride tube with a standard bevel, and the other was a newly designed tube with a hemispherical bevel. The outer diameters (OD) of the two TEs were 2.5 and 5.0 mm. After the standard induction of anesthesia, followed by vecuronium-induced paralysis, a TE was inserted into the trachea with a direct laryngoscope. By using the introducer as a guide, the tracheal tube was inserted into the trachea. The difficulty in passing the tube was assessed by a blinded observer and graded with a four-point scale. The newly designed tube was inserted more smoothly than was the conventional tube when the 2.5-mm-OD TE was used (P < 0.01). In situations such as those occurring after one-lung anesthesia, when use of a thicker TE is not applicable, this newly designed taper-tipped tube may be considered as an adjunct to oral tracheal tube exchange, using a thinner (smaller-OD) TE as the guide for tracheal intubation.


CONCLUSIONS
In situations such as after one-lung anesthesia, when use of a thicker tube exchanger (TE) is not applicable, a newly designed taper-tipped tube with the leading edge in the midline may be considered as an adjunct to an oral tracheal tube exchange, using a thinner TE as the guide for tracheal intubation.
Makino
Hiroshi
H
Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Japan.
Katoh
Takasumi
T
Kobayashi
Syunji
S
Bito
Hiromichi
H
Sato
Shigehito
S
D000769:Anesthesia, Inhalation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D007828:Laryngoscopy; D007830:Larynx / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011143:Polyvinyl Chloride
D011143:Polyvinyl Chloride