Wire reinforced endotracheal tube compared with Parker Flex-Tip tube for oral fiberoptic intubation: a randomized clinical trial

Abstract

Background: The aim of the study was to compare the Parker Flex-Tip (PFT) (group P) tube to a wire reinforced tracheal tube in two orientations, i.e., with posteriorly and anteriorly positioned tip bevels (WRP and WRA groups, respectively), for oral fiberoptic intubation.

Methods: This was a randomized clinical trial, carried out at the University-affiliated hospital. Ninety adult ASA physical status I-II patients who were scheduled to undergo either ophthalmic or urologic surgery were included in the study and randomly assigned to the P, WRA, or WRP group. Our primary outcome was the difficulty in advancing the tube over the fiberscope, which was quantified in grades (0, 1, or 2). Secondary outcomes were the time to visualize the carina after inserting the scope into the mouth and the time from this point to tracheal intubation.

Results: Endotracheal tube (ETT) advancement was easier and faster in the WRP and P groups than in the WRA. (Successful endotracheal intubation on the first attempt 67%, 60% and 20%, respectively; P=0.03) (ETT advancement time 6.9±3.5 s, and 8±3.1 s, 11.7±4.6, respectively; P<0.001).

Conclusion: Advancement of the ETT over a fiberoptic bronchoscope was easier with the PFT tube and with a posteriorly positioned wire-reinforced tube than with an anteriorly positioned wire-reinforced tube.