Utility of the Portex Introducer, Ivory Type, as a Tube Exchanger
Purpose
This study compared the Portex introducer, ivory type (PII) (Portex Tracheal Tube Introducer; SIMS Portex, Hythe, Kent, England), and Cook Airway Exchange Catheter (CAEC) (Cook, Letchworth, Hertfordshire, England) with regard to success rate of and time required for tracheal intubation by use of each device by oral and maxillofacial surgeons on a manikin.
Materials and Methods
The subjects comprised 17 oral and maxillofacial surgeons who intubated the trachea of the manikin with each device. The PII or CAEC was inserted into the trachea of the manikin and advanced 26 cm from the upper incisor, and the time required for intubation was measured. The subjects were then asked to rate the difficulty of intubation using a 10-cm visual analog scale.
Results
The mean intubation time, averaged over 3 attempts, was significantly shorter for the PII (7.92 ± 3.15 seconds) than for the CAEC (11.44 ± 3.98 seconds) (P < .001). The rate of successful intubation with the PII (88.2%) was significantly greater than that with the CAEC (37.3%) (P < .001). With regard to the overall difficulty of intubation, as rated by the 10-cm visual analog scale, the PII (median, 45 mm [10th-90th percentile, 32-53 mm]) was considered less difficult than the CAEC (median, 66 mm [10th-90th percentile, 52-84 mm]) (P < .001).
Conclusions
Intubation is faster, more sure, and easier by use of the PII as a tube exchanger than with the CAEC. This may be particularly important for patients undergoing oral and maxillofacial surgery as a result of anatomic changes in the airway, because edema or hematoma in the upper airway often leads to failed intubation. We conclude that the PII is useful as a tube exchanger.
⁎Staff Anesthesiologist, Department of Anesthesiology, Osaka Dental University, Osaka, Japan
†Staff Anesthesiologist, Department of Anesthesia, Hirakata City Hospital, Osaka, Japan
‡Graduate Student, Graduate School of Dentistry, Osaka Dental University, Osaka, Japan
§Professor, Department of Anesthesiology, Osaka Dental University, Osaka, Japan
Address correspondence and reprint requests to Dr Sanuki: Department of Anesthesiology, Osaka Dental University, 1-5-17 Otemae, Chuo-ku, Osaka 5400008, Japan
The authors did not contribute to the design or development of the Portex introducer, ivory type (PII), and have not received any payment or royalties from it. The PIIs used in this study were the property of the authors. The authors have no conflict of interest with regard to the PII.
ABSTRACT