Comparision between rae, flexometallic and PVC macintosh endotracheal tubes used in cleft palate surgery.
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Date
2016
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Abstract
Introduction: Cleft lip/palate are the most common craniofacial anomalies in children, with an incidence of CLP
worldwide is 1 in 700 live births. The risk factors are considered as Family history etc. Anaesthesia during cleft
lip and palate surgery carries a high risk and difficult airway management in children. Because of other
associated congenital anomalies, the anaesthetic management becomes more complicated. Flexometallic
endotracheal tubes, PVC macintosh tube, RAE tube are have their own risks and benefits when compared with
each other. This study was undertaken to compare ease of intubation ,ease of ventilation ,intra operative
maintenance of respiratory parameters ,intra-operative airway complication, post extubation complication by
using 3 different types of tubes (1) RAE (Ring Adair Elwyn) tube (2) flexometallic tube (3) PVC ( Polyvinyl
Chloride) macintosh tube in pediatric cleft palate surgeries.
Material & Methods: A randomized controlled trial was conducted on 90 ASA I and ASA II pediatric patients
of age group 9 month to 5 years undergoing cleft palate surgeries. Patients were randomly allocated in three
groups of 30 each. Group 1: intubated with R A E endotracheal tube, Group 2:intubated with flexometallictube
and Group 3: intubated with P V C macintosh endotracheal tube. The power of study on choosing such sample
size was found to be at 90% level. Time taken for intubation, No. of attempt taken for intubation, Monitoring of
capnography, SPO2, pulse rate and mean airway pressure every 15 minutes during the surgical procedures,
Endobronchial intubation, Inadvertent extubation, Ease of passing of suction catheter after application of
dingman retractor and Post extubation cough and croup was observed.
Results: The significant differences were observed in stylet used, ease of passing suction catheter and post
extubation cough and heart rate after retractor among the groups (p<0.05). All other differences were found to be
insignificant.
Conclusion: RAE tube provides a good approach for airway management in routine cleft lip surgeries. It
possesses advantage over flexometallic tube and PVC tube. As it is a preformed tube passing suction catheter is
technically difficult.
Description
Keywords
RAE tube, Flexomettalic tube, PVC tube, Cleft palate
Citation
Agrawal Apurva, Sharma Manoj Kumar, Agrawal Shailey, Arora Veena, Somvanshi Rituj. Comparision between rae, flexometallic and PVC macintosh endotracheal tubes used in cleft palate surgery. National Journal of Medical and Allied Sciences. 2016; 5(2): 97-102.