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A new tracheal tube for difficult intubation
M R West1, M M Jonas, A P Adams
1Department of Anaesthetics, United Medical and Dental School of Guy's and St Thomas's Hospitals, London.
British Journal of Anaesthesia
|May 1, 1996
Summary
A new Portex tracheal tube, modified for difficult intubations, performed comparably to the Oxford tube. Both tubes prevented cord obstruction, offering safety and convenience benefits for trainees practicing simulated grade 3 difficult intubations.
Area of Science:
- Anesthesiology
- Medical Devices
- Airway Management
Background:
- Difficult intubation presents significant challenges in anesthesia.
- Existing devices like the Oxford tube aim to improve success rates.
- Standard Magill tubes can cause obstruction when used with introducers.
Purpose of the Study:
- To compare a modified Portex tracheal tube with the Oxford tube in simulated grade 3 difficult intubations.
- To evaluate the safety, efficacy, and learning curve associated with the new Portex tube.
Main Methods:
- Simulated grade 3 difficult intubations were performed using a modified Portex tube and an Oxford tube.
- Both tubes utilized a gum elastic introducer.
- Data collected included intubation time, number of attempts, hemodynamic changes, and sore throat incidence.
Main Results:
- Both the modified Portex tube and the Oxford tube successfully avoided cord obstruction.
- A significant learning effect was observed, with intubation time decreasing progressively (P < 0.001).
- The learning "half-life" was estimated at 15 intubations, suggesting a need for practice.
Conclusions:
- The modified Portex tracheal tube offers advantages over traditional tubes for difficult intubations.
- It provides the benefits of the Oxford tube without rubber disadvantages, enhancing safety, cost-effectiveness, and convenience.
- Trainees require approximately 30 simulated grade 3 intubations to achieve proficiency.