Hwan S Joo1, Viren N Naik, Georges L Savoldelli. 1. Department of Anesthesia, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. hwanjoomd@yahoo.com
Abstract
PURPOSE: Difficulty can be encountered during advancement of the tracheal tube (TT) over the bronchoscope after successful endotracheal bronchoscopy due to impingement on laryngeal structures. A new TT, the Parker Flex-Tip (PFT), has been shown to be superior to polyvinylchloride (PVC) TTs in anesthetized, paralyzed patients with normal airways. However, no study to date has shown the superiority of the new tapered tip design in patients with difficult airways during awake fibreoptic intubations (AFOI). The purpose of this study was to compare the PFT with PVC TTs for AFOI in patients with difficult airways or unstable c-spines. CLINICAL FEATURES: In this prospective observational study, 111 patients with predicted or documented difficult airways, or unstable c-spines were assessed for ease of TT advancement during AFOI. First attempt success rates were 91% for PFT TTs and 84% for PVC TTs (P = NS). Resistance to TT advancement was none to mild and similar in both groups. Advancement without the need to rotate the TT 180 degrees was also similar in both groups (57% vs 53%). CONCLUSION: For AFOI in patients with difficult airways, the PFT is not superior to conventional PVC TTs.
PURPOSE: Difficulty can be encountered during advancement of the tracheal tube (TT) over the bronchoscope after successful endotracheal bronchoscopy due to impingement on laryngeal structures. A new TT, the Parker Flex-Tip (PFT), has been shown to be superior to polyvinylchloride (PVC) TTs in anesthetized, paralyzedpatients with normal airways. However, no study to date has shown the superiority of the new tapered tip design in patients with difficult airways during awake fibreoptic intubations (AFOI). The purpose of this study was to compare the PFT with PVC TTs for AFOI in patients with difficult airways or unstable c-spines. CLINICAL FEATURES: In this prospective observational study, 111 patients with predicted or documented difficult airways, or unstable c-spines were assessed for ease of TT advancement during AFOI. First attempt success rates were 91% for PFT TTs and 84% for PVC TTs (P = NS). Resistance to TT advancement was none to mild and similar in both groups. Advancement without the need to rotate the TT 180 degrees was also similar in both groups (57% vs 53%). CONCLUSION: For AFOI in patients with difficult airways, the PFT is not superior to conventional PVC TTs.