Shahram Nafisi^*, Mehdi Rajabi, Mohammad Afshar, Morteza Rashidian, Mitra Mohammadzadeh

Show more
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
Department of Anesthesia and Critical Care, Kashan University of Medical Sciences, Kashan, Iran.
Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
Clinical Innovation Ins Trials, Costa Mesa?, CA?, USA.
Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Show less

Abstract: Background: Comparison of the tracheal tube depth over the same body height of men and women based upon intubation depth markings. Methods: Kashan University of Medical Sciences ethics committee approved the study and written informed consent was taken for each patient. Patients undergoing surgery requiring general anesthesia with oro-tracheal intubation were included in a prospective observational study. After induction of general anesthesia, the endotracheal tube was secured at the point at which the cuff was just below the vocal cord on laryngoscopy. Results: In a statistical study of 682 intubated patients which consisted of 499 women and 183 men, 28 cases of laryngoscopic view grade III and IV were excluded from the study. The measurement markings on the ETT at the level of right corner of the mouth were 20.65 ± 0.13 and 18.52 ± 0.08 for men and women respectively (CI 95%). Patient’s height has a meaningful correlation with the measurement of the fixation point of the ETT. Pearson correlation coefficient between the securing point of the tube and height was 0.2 and 0.357 for men and women respectively. In most cases of men and women of the same height, Mann-Whitney U test rejected the hypothesis that the tube can be fixed in the particular point. Conclusions: In general, men are taller than women. Comparing the fixation depth of the tube, even when man and woman have the same body height, the endotracheal tube might be placed in a deeper level for men rather than women.

Keywords: Intubation, Endotracheal Tube, General Anesthesia, Height, Cuffed

Cite this paper: Nafisi, S. , Rajabi, M. , Afshar, M. , Rashidian, M. and Mohammadzadeh, M. (2014) A Comparison of the Best Place to Fix Endotracheal Tubes for Men and Women When Men and Women Are in the Same Height. Open Journal of Anesthesiology, 4, 153-158. doi: 10.4236/ojanes.2014.47021.

References

[1]   Szekely, S.M., Webb, R.K., Williamson, J.A. and Russell, W.J. (1993) Problems Related to the Endotracheal Tube: An Analysis of 2000 Incident Reports. Anaesthesia and Intensive Care, 21, 611-616.

[2]   Engoren, M. and de St. Victor, P. (2000) Tension Pneumothorax and Controlateral Presumed Pneumothorax from Endobronchial Intubation via Cricothyroidotomy. Chest, 118, 1833-1835. http://dx.doi.org/10.1378/chest.118.6.1833

[3]   Owen, R.L. and Cheney, F.W. (1987) Endobronchial Intubation: A Preventable Complication. Anesthesiology, 67, 255-257.
http://dx.doi.org/10.1097/00000542-198708000-00019

[4]   Cormack, R.S. and Lehane, J. (1984) Difficult Tracheal Intubation in Obstetrics. Anesthesia, 39, 1105-1111.
http://dx.doi.org/10.1111/j.1365-2044.1984.tb08932.x

[5]   Salem, M.R. (2001) Verification of Endotracheal Tube Position. Anesthesiology Clinics of North America, 19, 813-839.
http://dx.doi.org/10.1016/S0889-8537(01)80012-2

[6]   McCoy, E.P., Russell, W.J. and Webb, R.K. (1997) Accidental Bronchial Intubation: An Analysis of AIMS Incident Reports from 1988 to 1994 Inclusive. Anaesthesia, 52, 24-31.
http://dx.doi.org/10.1111/j.1365-2044.1997.007-az007.x

[7]   Cheney, F.W. (1991) A Caution on the Use of Routine Depth of Insertion of Endotracheal Tubes: In Reply. Anesthesiology, 74, 962-963.
http://dx.doi.org/10.1097/00000542-199105000-00042

[8]   Cherng, C.-H., Wong, C.-S., Hsu, C.-H. and Ho, S.-T. (2002) Airway Length in Adults: Estimation of Optimal Endotracheal Tube Length for Orotracheal Intubation. Journal of Clinical Anesthesia, 14, 271-274.
http://dx.doi.org/10.1016/S0952-8180(02)00355-0

[9]   Chong, D.Y.C., Greenland, K.B., Tan, S.T., Irwin, M.G. and Hung, C.T. (2006) The Clinical Implication of the Vocal Cord-Carina Distance in Anaesthetized Chinese Adults during Orotracheal Intubation. British Journal of Anaesthesia, 97, 489-495.
http://dx.doi.org/10.1093/bja/ael186

[10]   Eagle, C.C.P. (1992) The Relationship between a Person’s Height and Appropriate Endotracheal Tube Length. Anaesthesia and Intensive Care, 20, 156-160.

[11]   Roberts, J.R., Spadafora, M. and Cone, D.C. (1995) Proper Depth Placement of oral Endotracheal Tubes in Adults Prior to Radiographic Confirmation. Academic Emergency Medicine, 2, 20-24.
http://dx.doi.org/10.1111/j.1553-2712.1995.tb03073.x

[12]   Reed, D.B. and Clinton, J.E. (1997) Proper Depth of Placement of Nasotracheal Tubes in Adults Prior to Radiographic Confirmation. Academic Emergency Medicine, 4, 1111-1114.
http://dx.doi.org/10.1111/j.1553-2712.1997.tb03691.x

[13]   Pollard, R.J. and Lobato, E.B. (1995) Endotracheal Tube Location Verified Reliably by Cuff Palpation. Anesthesia and Analgesia, 81, 135-138.