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Evaluation of Time Taken to Confirm Tracheal Intubation in Real Time by Ultrasound versus Capnography in Elective General Anaesthesia Cases

Ashok Kumar B., Assistant Professor, Department of Anaesthesiology, Critical Care and Pain Management, Saveetha Medical College Hospital, Saveetha University, Thandalam, Chennai 602 105, Tamil Nadu, India. , Ashok Kumar Balasubramanian1 , Gunasekeran Kaliyaperumal2

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Indian Journal of Anesthesia and Analgesia 4(3):p 623-628, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.12

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Abstract

 Aim: 1. To study, the use of Ultrasound in confirming tracheal intubation. 2. To identify Oesophageal intubation and time taken for it. 3. Subsequent, evaluation of the time taken to confirm tracheal intubation by Ultrasound and Capnography. Methods and Material: 30 patients with ASA physical status 1 and 2, scheduled to undergo elective surgeries under general anesthesia were included in the study. The patient’s characteristics, airway measurements and baseline hemodynamic parameters were recorded preoperatively. Anesthetic management was standardized. The ultrasound transverse high frequency linear probe (9.3MHz-15MHz) was kept on suprasternal notch and moved slightly towards left. The esophagus on this view at the level of suprasternal notch lied posterolateral to the trachea. When, laryngoscopy was performed, the cormack-lehan grade was noted. The anesthesiologist doing ultrasonography, simultaneously evaluates the time taken to confirm endotracheal intubation by Ultrasonagraphy and Capnography. In case of oesophageal intubation,it is identified by appearance of “double track” sign. The time taken to identify the same is noted. Statistical Analysis Used: Mean, standard deviation, difference in mean. Results: The patient characteristics and demographic profile were found to be statistically similar. In our study, oesophageal Intubation is identified by ultrasound as early as 2 seconds in one case. The mean time taken to confirm endotracheal intubation in the rest of 29 patients by ultrasound was 17.5 seconds and by capnography was 41.63 seconds.The confirmation of endotracheal intubation by USG was on average 24 seconds earlier than by Capnography. Conclusions: Ultrasound is a rapid and reliable way to confirm proper endotracheal intubation.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.12

Keywords

Ultrasonagraphy; Capnography; Confirmation of Tracheal Intubation; Oesophageal Intubation.

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