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Laryngeal morbidity after tracheal intubation: the E ndoflex ® tube compared to conventional endotracheal intubation with stylet
Author(s) -
SØRENSEN M. K.,
RASMUSSEN N.,
KRISTENSEN M. S.,
BØTTGER M.,
FREDENSBORG B. B.,
HANSEN C. M.,
RASMUSSEN L. S.
Publication year - 2013
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12079
Subject(s) - stylet , medicine , intubation , tracheal tube , anesthesia , endotracheal tube , tracheal intubation , larynx , surgery , tube (container) , general anaesthesia , endotracheal intubation , mechanical engineering , engineering
Background Tracheal intubation may cause vocal fold damage. The trial was designed to assess laryngeal morbidity comparing the E ndoflex ® tube with a conventional endotracheal tube with stylet. We hypothesised that laryngeal morbidity within the first 24 h after extubation would be lower with the E ndoflex tube than with the conventional endotracheal tube with stylet because of less rigidity. Methods This randomised trial included 130 elective surgical patients scheduled for general anaesthesia with endotracheal intubation. Pre‐ and post‐operative assessment of hoarseness, vocal fold pathology, and voice analysis using the M ultidimensional V oice P rogram was performed. Induction of anaesthesia was standardised. After complete neuromuscular paralysis, intubation was done with an E ndoflex tube or a conventional endotracheal tube with stylet. Results Post‐operative hoarseness was found in 45% with the E ndoflex tube and 55% with the endotracheal tube with stylet at 24 h after extubation ( P = 0.44). Post‐operative vocal fold injury was present in 23% in the E ndoflex tube group and in 36% in the endotracheal tube with stylet group ( P = 0.13). The increase in shimmer, the voice analysis variable reflecting vocal fold oedema, was 0.5% in the E ndoflex tube group and 2.5% in the endotracheal tube with stylet group ( P = 0.02). Conclusion No significant difference was found in the incidence of hoarseness or vocal fold injury using the E ndoflex tube. However, the statistically significant lower increase in the shimmer values in that group implies that the E ndoflex may be associated with less laryngeal morbidity.