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

2003 ◽  
Vol 98 (2) ◽  
pp. 354-358 ◽  
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.

Can intubation confirmed by capnography be misleading? Complication with rabbit intubation

2020 ◽  
Vol 8 (2) ◽  
pp. e001043
Author(s):  
Ivana Calice ◽  
Attilio Rocchi
Keyword(s):  
Case Report ◽  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Orotracheal Intubation ◽  
Large Defect

Rapid and accurate tracheal intubation in rabbits is challenging. It requires skill and is a technically demanding procedure. Visualisation of a normal capnography trace is widely considered the most objective indication of a correct orotracheal intubation, especially with blind intubation and small tidal volumes. This case report describes how a large defect in the oesophageally dislocated endotracheal tube led to misleading positive capnography signal.

scholarly journals Comparison of three fixation methods for orotracheal intubation in 95 adults

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ye Sun ◽  
Hua Fan ◽  
Xiao-Xia Song ◽  
Hua Zhang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Older People ◽  
Endotracheal Intubation ◽  
Orotracheal Intubation ◽  
The Other ◽  
Fixation Methods ◽  
The Difference

Abstract Background The present study aimed to compare three fixation methods for orotracheal intubation. Methods Through literature retrieval, the effects of the adhesive/twill tape method, fixator method, and adhesive/twill tape–fixator alternation method on patients with tracheal intubation in the intensive care unit (ICU) were compared. Results The fixator and alternation methods were more effective in protecting the tongue mucosa and teeth. The alternation method was superior to the other two methods in maintaining the position of the endotracheal intubation. However, the difference in facial and lip injuries between the three methods was not statistically significant. Conclusion The fixator method can significantly reduce intraoral injury and is more suitable for older people with weak tongue mucosa and loose teeth. These are worth popularizing among a wider group.

scholarly journals I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Chaoliang Tang ◽  
Xiaoqing Chai ◽  
Fang Kang ◽  
Xiang Huang ◽  
Tao Hou ◽  
...  
Keyword(s):  
Stress Response ◽  
Tracheal Intubation ◽  
Adverse Events ◽  
Endotracheal Tube ◽  
Posterior Fossa ◽  
Carbon Dioxide Tension ◽  
Uneventful Recovery ◽  
Posterior Fossa Surgery ◽  
Necrosis Factor Alpha ◽  
Respiratory Variables

Background. The adverse events induced by intubation and extubation may cause intracranial hemorrhage and increase of intracranial pressure, especially in posterior fossa surgery patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients.Methods. Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT) or I-gel facilitated endotracheal tube intubation (Group TI). Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared.Results. Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P<0.05versus Group TT). Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasmaβ-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI.Conclusion. Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery.

scholarly journals Submental method for orotracheal intubation in treating facial trauma

1998 ◽  
Vol 116 (5) ◽  
pp. 1829-1832 ◽  
Author(s):  
Luiz Carlos Manganello-Souza ◽  
Nicolas Tenorio-Cabezas ◽  
Luiz Piccinini Filho
Keyword(s):  
Tracheal Intubation ◽  
General Anesthesia ◽  
Surgical Intervention ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Surgical Team ◽  
Visible Scar ◽  
Alternative Method

OBJECTIVE: To demonstrate an alternative method for intubating patients with fractures of maxilla and nose, prior to surgery. DESIGN: Cases Report. PARTICIPANTS: We studied 10 patients with facial fractures that affected maxilla and nose. INTERVENTION: The patients were submitted to surgery under general anesthesia and submental oro-tracheal intubation. RESULTS: This type of intubation allowed the surgical team to work on the whole face of the patient and left no visible scar. CONCLUSION: This procedure is indicated for patients with fractures of maxilla and nose who need surgical intervention under general anesthesia.

Comparison of the Intubating Laryngeal Mask Airway with the Fiberoptic Intubation in Anticipated Difficult Airway Management

2001 ◽  
Vol 94 (6) ◽  
pp. 968-972 ◽  
Author(s):  
Olivier Langeron ◽  
François Semjen ◽  
Jean-Louis Bourgain ◽  
Alain Marsac ◽  
Anne-Marie Cros
Keyword(s):  
Laryngeal Mask Airway ◽  
Tracheal Intubation ◽  
Adverse Events ◽  
Oxygen Saturation ◽  
Difficult Airway ◽  
Difficult Intubation ◽  
Laryngeal Mask ◽  
Fiberoptic Intubation ◽  
Alternative Technique ◽  
Intubating Laryngeal Mask Airway

Background The intubating laryngeal mask airway (ILMA; Fastrach; Laryngeal Mask Company, Henley-on-Thames, UK) may provide an alternative technique to fiberoptic intubation (FIB) to facilitate the management of the anticipated difficult airway. The authors therefore compared the effectiveness of the ILMA with FIB in patients with anticipated difficult intubation. Methods One hundred patients, with at least one difficult intubation criteria (Mallampati class III or IV, thyromental distance &lt; 65 mm, interincisor distance &lt; 35 mm) were enrolled (FIB group, n = 49; ILMA group, n = 51) in this prospective randomized study. Anesthesia was induced with propofol and maintained with alfentanil and propofol after an efficient mask ventilation has been demonstrated. The success of the technique (within three attempts), the number of attempts, duration of the successful attempt, and adverse events (oxygen saturation &lt; 90%, bleeding) were recorded. Results The rate of successful tracheal intubation with ILMA was 94% and comparable with FIB (92%). The number of attempts and the time to succeed were not significantly different between groups. In case of failure of the first technique, the alternative technique always succeeded. Failures in FIB group were related to oxygen desaturation (oxygen saturation &lt; 90%) and bleeding, and to previous cervical radiotherapy in the ILMA group. Adverse events occurred significantly more frequently in FIB group than in ILMA group (18 vs. 0%, P &lt; 0.05). Conclusion The authors obtained a high success rate and comparable duration of tracheal intubation with ILMA and FIB techniques. In patients with previous cervical radiotherapy, the use of ILMA cannot be recommended. Nevertheless, the use of the ILMA was associated with fewer adverse events.

scholarly journals Fibreoptic Orotracheal Intubation of Obese Patients Using Parker Flex-Tip vs. Standard Endotracheal Tube

2019 ◽  
Vol 47 (5) ◽  
pp. 387-391
Author(s):  
Lee C. Chang ◽  
◽  
Susan C. Lee ◽  
Andrew L. Ding ◽  
Suman Rajagopalan ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Orotracheal Intubation ◽  
Obese Patients

scholarly journals Comparison of Airtraq® Laryngoscope, Bonfils Endoscope and Fiberoptic Bronchoscope for Awake Tracheal Intubation: A Randomized, Controlled Trial

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Köhne W ◽  
◽  
Elfers-Wassenhofen A ◽  
Nosch M ◽  
Groeben H ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Local Anesthesia ◽  
Difficult Intubation ◽  
Spontaneous Breathing ◽  
Case Reports ◽  
Controlled Trial ◽  
Fiberoptic Intubation ◽  
Randomized Controlled ◽  
Glottic View

Over the last decades several indirect laryngoscopes have been developed to provide a significant better glottic view and improved the success rate in difficult intubations. Some case reports describe the use of indirect laryngoscopes for awake tracheal intubations under preserved spontaneous breathing. However, randomized clinical studies comparing indirect laryngoscopy to the standard of fiberoptic intubation under spontaneous breathing are rare. Therefore, we compared the intubation with the Airtraq® laryngoscope and the Bonfils endoscope, to the standard fiberoptic intubation in patients with an expected difficult intubation under local anesthesia and sedation. 150 patients with an expected difficult intubation were randomized to one of the three devices. All intubation attempts were performed under local anesthesia and sedation. We evaluated success rate, time for intubation and the satisfaction of anesthesiologists and patients. Fiberoptic intubation was significantly more successful (100%) than intubation with an Airtraq® laryngoscope (88%) or the Bonfils endoscope (88%). Time for intubation was quickest with the Airtraq® laryngoscope and significantly shorter than fiberoptic intubation (p=0.044). There was no difference in satisfaction of the anesthesiologists and none of the patients had a negative recall to one of the techniques. An expected difficult intubation can be managed using the Airtraq® laryngoscope or the Bonfils endoscope in 88% and shows the same satisfaction of anesthesiologists and patient. We conclude that these techniques represent an acceptable alternative for an awake tracheal intubation under sedation and preserved spontaneous breathing.

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