Tracheal intubation with the rigid tube for laryngoscopy – A new method

Abstract

Background: The rigid tube for laryngoscopy is an instrument used in ENT, for inspecting the larynx and its vicinity. We used it to facilitate intubation, in ENT patients. Methods: Twenty patients attending for surgery were included for study. Group 1 (n=10) had no airway pathology but at least two predictors of an anatomically difficult airway. Group 2 (n=10) had an obstructing airway pathology. After anesthesia induction, classical laryngoscopy was performed, and intubation grade registered. Using the retromolar approach the rigid tube advanced slowly, the epiglottis was lifted, and the vocal cords were visualized. The bougie was introduced through the rigid tube into the trachea, the rigid tube was extracted, and the intubating tube was placed in the trachea, over the bougie. Results: The mean (SD) maneuver duration was 59.4 (18.2) sec. The Cormack-Lehane view of the glottis at classical laryngoscopy was poor in four patients in Group 1 and six patients in Group 2. The lowest desaturation was 82%. No complications other than sore throat were noted. Conclusion: The rigid tube for laryngoscopy is a useful tool for intubation in ENT patients. We noticed an advantage against classical intubation in patients with base of tongue carcinoma, reduced mouth opening and protruding upper incisors with this instrument.