Tracheal soiling with blood during intranasal surgery--comparison of two endotracheal tubes

Sixty adult patients, ASA Classes I & II, were involved in a study to compare the effectiveness of Mallinckrodt Hi-Lo-Evac tube and Portex blue line tube in preventing soiling of the lower airways during intranasal surgery. The Hi-Lo-Evac tube with and without pack was significantly more effective than the Portex tube with pharyngeal pack (P less than 0.002) and (P less than 0.01 respectively). There was no significant difference when the Hi-Lo-Evac tube was used with or without a pack (P greater than 0.2). The more effective protection of the lower airways by the Hi-Lo-Evac tube is attributed to the facility of subglottic aspiration during surgery. It is suggested that the Hi-Lo-Evac tube could be used with safety during intranasal surgery in order to reduce postoperative morbidity associated with the use of pharyngeal pack.