Utility of the Portex Introducer, Ivory Type, as a Tube Exchanger

• Published in: Journal of oral and maxillofacial surgery Vol. 67; no. 8; pp. 1615 - 1618
• Main Authors: Sanuki, Takuro, DDS, PhD, Son, Hiroki, DDS, PhD, Kishimoto, Naotaka, DDS, Kotani, Junichiro, DDS, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-08-2009; Elsevier
• Subjects: Attitude of Health Personnel; Biological and medical sciences; Dentistry; Equipment Design; Esophagus; Foreign Bodies - etiology; Humans; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Manikins; Medical sciences; Otorhinolaryngology. Stomatology; Surgery; Surgery, Oral; Time Factors; Treatment; Tube; Stomatology; Surgery
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2008.09.017

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.