Title: Evaluation of Conventional Cuffed Polyvinyl Chloride (PVC) Tube for Intubation through Intubating Laryngeal Mask Airway (LMA)
Authors: Dr Shruti Khatkhedkar, Dr Sandhya Bakshi
DOI: http://dx.doi.org/10.18535/jmscr/v3i11.39
The rationale of the study is to evaluate the feasibility of conventional cuffed polyvinyl chloride (PVC) endotracheal tube for intubation through intubating laryngeal mask airway. The design was a prospective, randomized study enrolling eighty patients of either sex, ASA grade I & II, MPG grade I & II posted for various elective surgeries under general anaesthesia. Two groups of patients were randomly selected to compare the clinical performance of conventional cuffed PVC with FTST for tracheal intubation through ILMA.Continuous variables were compared between 2 groups by performing un-paired t-test. Categorical variables were compared by using Pearson’s chi-square test. For small numbers, Fisher’s exact test was applied wherever applicable. Statistical software STATA version 13.1 was used for statistical analysis. Mean time required for insertion of ILMA in group I (FTST) was comparable statistically with group II (PVC). Incidence of successful intubation in first attempt was more in FTST group as compared to PVC group but it was not statistically significant. PVC group more frequently required maneuvers for successful intubation than FTST group. However overall success rate of intubation and time required for intubation in both the groups was comparable. The laryngopharyngeal complications observed in the present study were comparable in both the groups. The present study concluded that conventionally used cuffed PVC tube can be a feasible alternative to routinely used FTST with comparable success rate, time required for insertion and laryngopharyngeal complications. 1. Samsoon GL, Young JR. Difficult tracheal intubation: a retrospective study. Anaesthesia 1987;42:487-90. 2. Benumof JL. Management of the difficult aiway with special emphasis on awake tracheal intubation. Anesthesiology 1991;75:1087-1110. 3. Caplan RA, Posner KL, Ward RJ, Cheney FW. Adverse respiratory events in anesthesia: a closed claims analysis. Anesthesiology 1990;72:828-33. 4. Brain AIJ. Three cases of difficult intubation overcome by the laryngeal mask airway. Anaesthesia 1985;40:353–5. 5. Parmet JL, Colonna-Romano P, Horrow JC, Miller F, Gonzales J, Rosenberg H. The laryngeal mask airway reliably provides rescue ventilation in case of unanticipated difficult tracheal intubation along with difficult mask ventilation. Anesth Analg 1998;87:661–5. 6. Joo HS, Rose DK. The intubating laryngeal mask airway with or without fibreoptic guidance. Anaesth Analg 1999;88:662-6. 7. Brain AIJ, Verghese C, Addy EV, Kapila A. The intubating laryngeal mask I: Development of new device for intubation of the trachea. Br. J Anaesthesia 1997;79:699-703. 8. Kundra P, Sujata N, Ravishankar M. Conventional Tracheal Tubes for Intubation through the intubating Laryngeal Mask Airway. Anesth Analg 2005;100:284-8. 9. Brain AIJ, Verghese C, Addy EV, Kapila A, Brimacombe J. The intubating laryngeal mask. II: a preliminary clinical report of a new means of intubating the trachea. Br J Anaesth 1997;79:704–9. 10. Zhu T. Conventional endotracheal tubes for intubation through intubating laryngeal mask airway. Anesth Analg 2007;104:213. 11. Sreeramalu SK, Prabhu JP, Gopal S. Comparison between Poly Vinyl Chloride (PVC) Tube and Intubating Laryngeal Mask Airway (ILMA) Tube for Intubation Through Intubating Laryngeal Mask Airway (ILMA / Lma-Fastrach) in Mallampati (MP) 3 and 4 Patients. J Evid Based Med and Hthc 2014;1(8):955-61. 12. Ye L, Liu J, Wong DT, Zhu T. Effects of tracheal tube orientation on the success of intubation through an intubating laryngeal mask airway: Study in Mallampati class 3 or 4 patients. Br J Anaesth 2009;102:269-72. 13. Benumof JL. Management of the difficult adult airway. With special emphasis on awake tracheal intubation. Anesthesiology 1991;75:1087–1110. 14. Kanazi GE, El-Khatib M, Nasr VG. 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 anaesthesia. Anesth Analg 2008;107:994–7. 15. Langenstein H, Möller F. First experience with the laryngeal intubation mask. Anaesthesist 1998;47(4):311-9. 16. Lu PP, Yang CH, Ho AC, Shyr MH. The intubating LMA: a comparison of insertion technique with conventional tracheal tubes. Can J Anesth 2000;47:849-53. 17. Sharma MU, Gombar S, Gombar KK, Singh B, Bhatia N. Endotracheal intubation through the intubating laryngeal mask airway (LMA-FastrachTM): A randomized study of LMA-FastrachTM wire-reinforced silicone endotracheal tube versus conventional polyvinyl chloride tracheal tube. Ind J Anaesthesia 2013;57:19-24. 18. Shah VR, Bhosale GP, Mehta T, Parikh GP. A comparison of conventional ebdotracheal tube with silicon wire-reinforced tracheal tube for intubation through intubating laryngeal mask airway. Saudi j Anaesthesia 2014;8:183-7. 19. Timmerman A et al. Evaluation of the CTrach- an intubating LMA with integrated fibreoptic system. Br.J Anaesthesis 2006; 96:516-21. Abstract
References