A Comparison of a Silicone Wire-Reinforced Tube with the Parker and Polyvinyl Chloride Tubes for Tracheal Intubation Through an Intubating Laryngeal Mask Airway in Patients with Normal Airways Undergoing General Anesthesia

Kanazi, Ghassan E.; El-Khatib, Mohammed; Nasr, Viviane G.; Kaddoum, Roland; Al-Alami, Achir A.; Baraka, Anis; Ayoub, Chakib M.

doi:10.1213/ane.0b013e31817ef110

Cited by 30 publications

(35 citation statements)

References 7 publications

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“…who compared the ease of intubation using WRS tube, Parker tube, and PVC tube through the ILMA. [5] They reported a success rate of 90%, 54%, and 48%, respectively, for the 3 groups without the use of manipulations and 90%, 86%, and 57%, respectively, with manipulations. The difference could be attributed to limited clinical experience in using PVC tubes with ILMA and the small sample size in their study.…”

Section: Discussionmentioning

confidence: 99%

Endotracheal intubation through the intubating laryngeal mask airway (LMA-Fastrach™): A randomized study of LMA- Fastrach™ wire-reinforced silicone endotracheal tube versus conventional polyvinyl chloride tracheal tube

Sharma

Gombar

et al. 2013

Indian J Anaesth

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Context:A wire-reinforced silicone tube (LMA-Fastrach™ endotracheal tube) is specially designed for tracheal intubation using intubating laryngeal mask airway (ILMA). However, conventional polyvinyl chloride (PVC) tracheal tubes have also been used with ILMA to achieve tracheal intubation successfully.Aim:To evaluate the success of tracheal intubation using the LMA-Fastrach™ tracheal tube versus conventional PVC tracheal tube through ILMA.Settings and Design:Two hundred adult ASA physical status I/II patients, scheduled to undergo elective surgery under general anaesthesia requiring intubation, were randomly allocated into two groups.Methods:The number of attempts, time taken, and manoeuvres employed to accomplish tracheal intubation were compared using conventional PVC tubes (group I) and LMA-Fastrach™ wire-reinforced silicone tubes (group II). Intraoperative haemodynamic changes and evidence of trauma and postoperative incidence of sore throat and hoarseness, were compared between the groups.Statistical Analysis:The data was analyzed using two Student's t test and Chi-square test for demographics and haemodynamic parameters. Mann Whitney U test was used for comparison of time taken for endotracheal tube insertion. Fisher's exact test was used to compare postoperative complications.Results:Rate of successful tracheal intubation and haemodynamic variables were comparable between the groups. Time taken for tracheal intubation and manoeuvres required to accomplish successful endotracheal intubation, however, were significantly greater in group I than group II (14.71±6.21 s and 10.04±4.49 s, respectively (P<0.001), and 28% in group I and 3% in group II, respectively (P<0.05)).Conclusion:Conventional PVC tube can be safely used for tracheal intubation through the ILMA.

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Section: Discussionmentioning

confidence: 99%

Endotracheal intubation through the intubating laryngeal mask airway (LMA-Fastrach™): A randomized study of LMA- Fastrach™ wire-reinforced silicone endotracheal tube versus conventional polyvinyl chloride tracheal tube

Sharma

Gombar

et al. 2013

Indian J Anaesth

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“…15 Due to its blunt tip, this tube is well-suited for blind insertion through the FT-LMA. It is important to maintain the orientation of the external black longitudinal line of the ETT with the patient's nose to insure the bevelled tip is appropriately oriented at the glottic opening.…”

Section: Endotracheal Tube Selectionmentioning

confidence: 99%

“…The use of a standard polyvinylchloride (PVC) ETT is feasible, but the success rates are lower with blind insertion because of the left-sided bevel and the propensity for arytenoid cartilages or false or true vocal cords to obstruct insertion. Kanazi et al 15 demonstrated a low first attempt success rate of 48% using a standard ETT that increased to only maximal. This ''first'' maneuver aligns the internal aperture with the glottic opening.…”

Section: Endotracheal Tube Selectionmentioning

confidence: 99%

The FastrachTM Intubating Laryngeal Mask Airway®: an overview and update

Gerstein

Braude

Hung

et al. 2010

Can J Anesth/J Can Anesth

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Purpose To provide an evidence-based overview and update on the use of the Fastrach TM Intubating Laryngeal Mask AirwayÒ (FT-LMA) when used within operative and non-operative settings. Principal findings The FT-LMA is available in three sizes to provide ventilation and the ability to pass an endotracheal tube (ETT) into the trachea blindly, semi-blindly, or with indirect visualization for patients over 30 kg. The Chandy maneuver is recommended routinely; the first maneuver optimizes ventilation, and the second maneuver increases success at endotracheal intubation (ETI). The manufacturer's reinforced tube or a pre-warmed or reversed standard ETT may be utilized. Insertion and ventilation are successful in almost all patients. Blind ETI is highly successful; adjuncts are generally not necessary. The FT-LMA has a proven role in the airway management of anticipated difficult operating room (OR) intubations, unanticipated OR intubations, cervical spine injuries, and limited airway access situations. Literature in the pre-hospital and emergency department settings is limited but favourable. The FT-LMA has compared favourably with fibreoptic intubation, the LMA-Classic TM , the laryngeal tube, and the CobraPLA TM . Initially, the more expensive LMA CTrach TM appeared to be more successful, but overall it is not. The FT-LMA airway seal pressures are excellent; serious complications are uncommon, and the FT-LMA figures prominently in most difficult airway guidelines. Conclusions The FT-LMA has proven to be a useful difficult airway device both within and outside of the operating room. Effective ventilation is established in nearly all cases, and blind ETI is possible in the vast majority of cases if the optimal techniques described are used. Serious complications are uncommon. Constatations principales Le FT-LMA est disponible en trois tailles pour permettre la ventilation et le passage d'une sonde endotrache´ale (SET) dans la trache´e de façon aveugle, semi-aveugle ou avec visualisation directe chez les patients pesant plus de 30 kg. La manoeuvre de Chandy est recommande´e de façon routinie`re; la premie`re manoeuvre optimise la ventilation, et la seconde augmente le succe`s lors d'une intubation endotrache´ale (IET). La sonde arme´e du fabricant ou une SET standard pre´chauffe´e ou inverse´e peut eˆtre utilise´e. L'insertion et la ventilation re´ussissent chez presque tous les patients. L'IET en aveugle a un taux de re´ussite e´leve´; en re`gle ge´ne´rale, les accessoires ne sont pas ne´cessaires. Le FT-LMA joue un rôle e´prouve´dans la prise en charge des voies ae´riennes lors d'intubations anticipe´es comme difficiles dans la salle d'ope´ration (SOP), d'intubations impre´vues en SOP, de le´sions de la colonne cervicale et dans les situations oul 'acce`s aux voies ae´riennes est limite´. La litte´rature portant sur son utilisation dans des contextes pre´-hospitaliers et dans le de´partement des urgences est restreinte mais favorable. Le FT-LMA a e´te´favorablement compare´al 'intubation par fibroscopie, au LMA...

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“…Kanazi et al . [15] reported 90% overall success rate with FTST compared with 57% with PVCT. This lower success rate was attributed to the impingement of the tip of the ETT on the tubercle of the epiglottis.…”

Section: Discussionmentioning

confidence: 99%

A comparison of conventional endotracheal tube with silicone wire-reinforced tracheal tube for intubation through intubating laryngeal mask airway

et al. 2014

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Background:A specially designed wire-reinforced endotracheal tube — the Fastrach silicone tube (FTST) designed to facilitate endotracheal intubation through intubating laryngeal mask airway (ILMA) are expensive and not readily available. Hence, it is worth considering alternative such as polyvinyl chloride tracheal tube (PVCT), which is disposable, cheap and easily available. The aim of the present study was to compare the clinical performance of FTST with conventional PVCT for tracheal intubation through ILMA.Methods:After informed consent, 60 ASA I-II adults with normal airway undergoing elective surgery were randomly allocated to undergo blind tracheal intubation through ILMA with a FTST or conventional PVCT. Overall success rate, ease of insertion, number of attempts for successful intubation, critical incidence during intubation and post-operative sore throat were compared.Results:The overall success rate with FTST was 96.63% and 93.33% with PVCT; in addition, the first-attempt success rate was 86.25% with FTST compared to 82.14% with PVCT. The time taken for intubation was 18.6 ± 6.8 s. in FTST group and 22.42 ± 8.5 s. in PVCT group. Incidence of sore throat was 21.42% in PVCT group compared with 6.89% in FTST group.Conclusion:Blind tracheal intubation through an ILMA with the conventional PVCT instead of FTST is a feasible alternative in patients with normal airways.

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A Comparison of a Silicone Wire-Reinforced Tube with the Parker and Polyvinyl Chloride Tubes for Tracheal Intubation Through an Intubating Laryngeal Mask Airway in Patients with Normal Airways Undergoing General Anesthesia

Abstract: Manipulation improved the success rate of intubation with the Parker tube through the ILMA rendering it a possible alternative to the silicone wire-reinforced tube.

Cited by 30 publications

References 7 publications

Endotracheal intubation through the intubating laryngeal mask airway (LMA-Fastrach™): A randomized study of LMA- Fastrach™ wire-reinforced silicone endotracheal tube versus conventional polyvinyl chloride tracheal tube

Endotracheal intubation through the intubating laryngeal mask airway (LMA-Fastrach™): A randomized study of LMA- Fastrach™ wire-reinforced silicone endotracheal tube versus conventional polyvinyl chloride tracheal tube

The FastrachTM Intubating Laryngeal Mask Airway®: an overview and update

A comparison of conventional endotracheal tube with silicone wire-reinforced tracheal tube for intubation through intubating laryngeal mask airway

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