Conversion of a Nasal to an Orotracheal Intubation Using an Endotracheal Tube Exchanger

Background Advancing the endotracheal tube (ETT) over a flexible bronchoscope (FB) during awake fiberoptic orotracheal intubation is often impeded. The goal of this study was to identify the sites and mechanisms that inhibit the passing of the ETT into the trachea. Methods Forty-five consenting patients underwent a clinically indicated awake fiberoptic orotracheal intubation. After topical anesthesia, nerve block, or both, an awake fiberoptic orotracheal intubation was performed. The placement of the FB and advancement of the ETT over the FB were videotaped using a second nasally inserted FB. An otolaryngologist later reviewed the videotaped data. Results The right arytenoid or the interarytenoid soft tissues inhibited advancement of the ETT in 42 and 11% of all patients, respectively. In all cases in which the FB was located on the right side of the larynx, failure of ETT advancement almost always occurred at the right arytenoid. Withdrawing the ETT and rotating it 90 degrees counterclockwise resulted in successful intubation on the second, third, and fourth attempts in 26.6, 20, and 0.7% of patients, respectively. Conclusion The right arytenoid frequently inhibits advancement of the ETT over the FB into the trachea during awake fiberoptic orotracheal intubation. The FB position in the larynx before tube advancement and the orientation of the ETT are relevant factors in failure of advancement of the ETT into the trachea. The authors recommend positioning the FB in the center of the larynx and orienting the bevel of the ETT to face posteriorly during the first attempt at intubation.

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Endoscopic Study of Mechanisms of Failure of Endotracheal Tube Advancement into the Trachea During Awake Fiberoptic Orotracheal Intubation

Survey of Anesthesiology ◽

10.1097/01.sa.0000220760.98651.ff ◽

2006 ◽

Vol 50 (3) ◽

pp. 159-160

Author(s):

&NA;

Keyword(s):

Endotracheal Tube ◽

Orotracheal Intubation ◽

Endoscopic Study

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STUDY ON BETAMETHASONE GELAND LIGNOCAINE JELLY APPLIED OVER ENDOTRACHEAL TUBE TO REDUCE POST OPERATIVE SORE THROAT, COUGH ANDHOARSENESS OF VOICE

10.36106/0118319 ◽

2021 ◽

pp. 15-16

Author(s):

Stalin Ramamoorthy ◽

Muthukumar Thangaraj

Keyword(s):

Endotracheal Tube ◽

General Anaesthesia ◽

Sore Throat ◽

Orotracheal Intubation ◽

Control Group ◽

Postoperative Sore Throat ◽

Lidocaine Group ◽

Group B ◽

Anaesthesia Care ◽

And Control

Background and Objectives: Controlled comparison between 0.05% betamethasone gel, 2% lidocaine jelly, lubricating gel applied over endotracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice at 0,6,&24 hrs Materials And Methods: This study compares the incidence of postoperative sore throat, cough, and hoarseness ovoice after general anaesthesia when applying betamethasone gel (betamethasone group-B) or lidocaine jelly( lidocaine group -L) on the tracheal tube. 120 ASAclass I and II patients undergoing elective surgeries under general anaesthesia with orotracheal intubation were randomized into three groups: betamethasone gel, lidocaine jelly, and control groups (C group). In the post-anaesthesia care unit, all patients were interviewed on postoperative sore throat, cough, and hoarseness of voice at 0, 6, and 24 h after surgery. Results and Conclusion:Awide spread application of betamethasone gel (B) on the endotracheal tube decreases the incidence and severity of postoperative sore throat, cough, and hoarseness of voice as compared to lignocaine group(L) and control group (c).

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The Parker Flex-Tip Tube versus a Standard Tube for Fiberoptic Orotracheal Intubation

Anesthesiology ◽

10.1097/00000542-200302000-00014 ◽

2003 ◽

Vol 98 (2) ◽

pp. 354-358 ◽

Cited By ~ 73

Author(s):

Michael S. Kristensen

Keyword(s):

Tracheal Intubation ◽

Endotracheal Tube ◽

Median Time ◽

Orotracheal Intubation ◽

Fiberoptic Intubation ◽

Grading System ◽

Plastic Bag ◽

New Type ◽

Tube Versus ◽

Opaque Plastic

Background During fiberoptic tracheal intubation, passage of the fiberscope itself to the trachea is often fairly easy, but passage of the tube into the trachea may be difficult or even impossible. A new type of disposable endotracheal tube, the Parker Flex-Tip tube, has a tip that reduces the gap between the fiberscope and the inside of the tube. Thus, theoretically, a smaller risk of impinging on laryngeal structures during insertion in trachea is expected. Methods Eighty patients scheduled for elective anesthesia using orotracheal intubation were randomized to either a Parker Flex-Tip tube or a standard (Portex) 7.5-mm-ID endotracheal tube. Blinding was obtained by having the tube premounted on the fiberscope (Olympus LF-1; diameter of fiberscope = 4 mm) and thereafter covered with a black opaque plastic bag. Difficulty in placing the tube was scored using an objective standardized grading system. Results Seventy-six patients completed the study. The use of the Parker Flex-Tip tube reduced the incidence of need for repositioning of the tube during insertion into trachea from 89% to 29% (P < 0.0001) when compared to the standard tube. The median time for passage of the tube into the trachea was reduced from 20 s to 7.5 s (P < 0.0001). Conclusions During oral fiberoptic intubation, the use of the Parker Flex-Tip tube is associated with greater incidence of initial success of passage of the tube into trachea when compared to a standard endotracheal tube.

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Use of an Endotrol® endotracheal tube to facilitate orotracheal intubation with videolaryngoscopes

Internal and Emergency Medicine ◽

10.1007/s11739-012-0774-0 ◽

2012 ◽

Vol 7 (4) ◽

pp. 389-391 ◽

Cited By ~ 1

Author(s):

Kun-Peng Liu ◽

Fu-Shan Xue ◽

Yi Cheng ◽

Rui-Ping Li

Keyword(s):

Endotracheal Tube ◽

Orotracheal Intubation

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