A Randomized Controlled Trial: Examining the Impact of the Novel Double Setup Endotracheal Tube on the Success Rates of Awake Fiber-Optic Orotracheal Intubation

Basic Science Investigations

Chen C.a· Li M.a· Yu Q.a· Zuo Y.a· Lin J.a· Li J.b· Shi Z.c

Author affiliations

aDepartment of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
bDepartment of Breast and Thyroid Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
cDepartment of Anesthesiology, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, China

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Article / Publication Details

Received: September 11, 2022
Accepted: February 20, 2023
Published online: March 15, 2023

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 4

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: Advancing the endotracheal tube (ETT) over a flexible bronchoscope (FB) during awake fiber-optic intubation (AFOI) is often impeded. Various maneuvers and tracheal tubes designed to overcome this obstruction may also be unsuccessful or costly. Objective: The current study aimed to assess how the novel double configuration ETT affected AFOI success rates on the first attempt. Methods: A randomized controlled experiment including 40 individuals receiving awake fiber-optic orotracheal intubation was performed in a 1:1 ratio with a single ETT railroaded with its bevel posteriorly (ST) or railroading with a double setup ETT (DT) over a flexible videoscope (FVS) for tracheal intubation. The number of intubation attempts, time spent intubating, and adverse events were examined and compared between the two groups. Results: Twenty patients received a single ETT railroaded with the bevel posteriorly, and 20 patients received railroading with the double setup ETT during AFOI. Intubation on the first attempt was significantly greater in the DT group (90%) than in the ST group (35%). The intubation time was considerably shorter for the DT group (12.8 [7.8–16.9] s) when compared with the ST group (27.9 [16.3–91.0] s). Five patients were intubated by the alternative technique after failure to intubate for several attempts, and 3 cases were found to have a crease in the FVS after intubation in group ST. During topical anesthetic, three individuals in each group experienced transient oxygen desaturation. Conclusions: Our study discovered that the novel double setup tube could significantly improve the intubation success rate on the first attempt during AFOI for patients with challenging airway when a strategy based on a reduced gap between ETT and FB could not be applied.

© 2023 S. Karger AG, Basel

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Received: September 11, 2022
Accepted: February 20, 2023
Published online: March 15, 2023

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 4

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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