TY - JOUR
T1 - The endotracheal tube moves more often in obese patients undergoing laparoscopy compared with open abdominal surgery
AU - Ezri, Tiberiu
AU - Hazin, Vadim
AU - Warters, David
AU - Szmuk, Peter
AU - Weinbroum, Avi A.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - We compared the incidence of movements of the endotracheal tube (ETT) within the trachea in morbidly obese patients undergoing either laparoscopic or open gastroplasty. In a double-blinded, prospective, controlled study, 60 patients (body mass index, 35-60 kg/ m2) were equally allocated to either laparoscopic Lap-Band gastroplasty (study group; Group 1) or open laparotomy gastroplasty (control; Group 2), both under standardized general anesthesia. Movements of the ETT were assessed with chest auscultation, peak inspiratory pressure, ETco2, Spo2, and the RapiscopeTM at predetermined time points: after intubation (baseline values), 5 min before peritoneal inflation in Group 1 and 10 min postintubation in Group 2, at maximal abdominal inflation in Group 1 and 20 min into the procedure in Group 2,5 min before and 5 min after changing the patient's position from neutral to 10° head up and 10° head down in Group 1 and 30 and 40 min into the procedure in Group 2,2 min after abdominal deflation and table repositioning in Group 1 and at 50 min in Group 2, and just before extubation in both groups. Twenty-one events of ETT tip movement occurred in both groups. The tube moved in 15 (50%) study (laparoscopy) group patients compared with 6 (20%) controls (laparotomy; P < 0.05), 12 of the former having moved downward either after maximal abdominal insufflation or in association with head-down positioning. The tubes of five study group patients (17%) advanced into the right bronchus, compared with none in the controls (P < 0.05). All changes in position were rectified only by the RapiscopeTM.
AB - We compared the incidence of movements of the endotracheal tube (ETT) within the trachea in morbidly obese patients undergoing either laparoscopic or open gastroplasty. In a double-blinded, prospective, controlled study, 60 patients (body mass index, 35-60 kg/ m2) were equally allocated to either laparoscopic Lap-Band gastroplasty (study group; Group 1) or open laparotomy gastroplasty (control; Group 2), both under standardized general anesthesia. Movements of the ETT were assessed with chest auscultation, peak inspiratory pressure, ETco2, Spo2, and the RapiscopeTM at predetermined time points: after intubation (baseline values), 5 min before peritoneal inflation in Group 1 and 10 min postintubation in Group 2, at maximal abdominal inflation in Group 1 and 20 min into the procedure in Group 2,5 min before and 5 min after changing the patient's position from neutral to 10° head up and 10° head down in Group 1 and 30 and 40 min into the procedure in Group 2,2 min after abdominal deflation and table repositioning in Group 1 and at 50 min in Group 2, and just before extubation in both groups. Twenty-one events of ETT tip movement occurred in both groups. The tube moved in 15 (50%) study (laparoscopy) group patients compared with 6 (20%) controls (laparotomy; P < 0.05), 12 of the former having moved downward either after maximal abdominal insufflation or in association with head-down positioning. The tubes of five study group patients (17%) advanced into the right bronchus, compared with none in the controls (P < 0.05). All changes in position were rectified only by the RapiscopeTM.
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U2 - 10.1097/00000539-200301000-00055
DO - 10.1097/00000539-200301000-00055
M3 - Article
C2 - 12505966
AN - SCOPUS:0037223642
SN - 0003-2999
VL - 96
SP - 278
EP - 282
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 1
ER -