Evaluation of tracheal tube introducers in simulated difficult intubation.
In a randomised cross-over study, 72 anaesthetists attempted to place Pro-Breathe, new Portex, and Frova single-use tracheal tube introducers and an Eschmann multiple-use introducer in the trachea of a manikin set to simulate a grade 3 laryngeal view. Successful placement (proportion, 95% confidence interval) of either the Frova (78%, 67-86%) or the Eschmann introducer (64%, 52-74%) was significantly more likely (p < 0.0001) than with the Pro-Breathe (4%, 1-12%) or the new Portex introducer (13%, 7-22%). The difference between the success rates for the Frova and the Eschmann introducers (p = 0.08) was not significant. A separate experiment revealed that the peak force that could be exerted by the Pro-Breathe, new Portex and Frova single-use introducers were three to six times greater than that which could be exerted by the Eschmann introducer (p < 0.0001). The single-use introducers are more likely to cause tissue trauma during placement, particularly if held close to the tip.
Janakiraman
C
C
Department of Anaesthetics and Intensive Care Medicine, Cardiff University, Cardiff, UK.
Hodzovic
I
I
Reddy
S
S
Desai
N
N
Wilkes
A R
AR
Latto
I P
IP
D002983:Clinical Competence; D018592:Cross-Over Studies; D004209:Disposable Equipment; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008348:Manikins; D013314:Stress, Mechanical