Prospective randomized comparison of the EasyTube and the esophageal-tracheal Combitube airway devices during general anesthesia with mechanical ventilation

Abstract

Study objective: To evaluate the ease of use of two airway devices, the EasyTube (EzT) versus the esophageal-tracheal Combitube (ETC).

Design: Prospective, randomized controlled trial.

Setting: University hospital.

Subjects: 80 adult, ASA physical status 1 and 2 patients scheduled for elective surgery.

Interventions: Patients' tracheas were intubated with the EzT or the ETC in randomized fashion.

Measurements: Difficulty of insertion, time to achieve an effective airway, insertion success rate, maneuvers to achieve an effective airway, oropharyngeal leak pressure, intracuff pressure, ventilatory parameters, success rate of gastric tube insertion, and frequency of adverse effects were compared.

Main results: Insertion was easier in the EzT than in ETC; insertion of the EzT was rated easy in 36 7 cases and moderately difficult in 4 cases versus 26 and 14 cases, respectively, for the ETC (P = 0.014). Less time was required to achieve an effective airway with the EzT than the ETC: 19.4 ± 5.3 sec versus 30.6 ± 4.1 seconds, respectively (P < 0.001). Oropharyngeal leak pressure was higher with the EzT than the ETC (34.3 ± 5.95 vs 31.6 ± 2.42 cm H(2)O; P = 0.011). Peak airway pressures for the EZT and the ETC were 22.2 ± 0.99 cm H(2)0 and 33.7 ± 1.82 cm H(2)O, respectively (P < 0.001). Gastric tube insertion was successful with both devices; however, the EzT allowed insertion of gastric tubes of wider diameter. No severe perioperative adverse events were recorded for either device.

Conclusion: The EzT has distinct advantages over the ETC in airway management, including shorter time to achieve an effective airway and easier insertion.