Ventilation with the esophageal-tracheal Combitube during general anaesthesia: assessing complications in 540 patients

Background: The esophageal-tracheal Combitube (ETC) was developed for the management of difficult airways but can also be used for general anaesthesia. Methods: This clinical study collected data from patients undergoing anaesthesia with the ETC in order to assess the rate of complications. Results: Five hundred forty patients were ventilated with the ETC. In 94.8% (512/540), insertion was performed for the first time by the respective physician. The following minor complications were observed: 38.7% sore throat, 30.9% blood on tube as sign of mucosal lesions and 17.0% cyanotic tongue. Experience decreased the risk of mucosal lesions (odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.5–3.5). A higher than recommended volume of the oropharyngeal cuff was associated with blood on the ETC (OR: 1.5, 95% CI: 1.0–2.3) and tongue cyanosis (OR: 2.3, 95% CI: 1.4–3.7). Ventilation for more than 2 h was associated with tongue cyanosis (OR: 2.2, 95% CI: 1.6–3.1) and tongue protrusion (OR: 1.4, 95% CI: 1.1–1.9). Conclusion: We conclude that the Combitube may be used for short procedures requiring general anaesthesia, but the high rate of minor complications limits its value when other alternatives such as a laryngeal mask airway are available. The tested method appears safe regarding major complications, but minor complications are common. Adherence to recommended cuff volumes, experience with the ETC and limiting its use to surgeries lasting less than 2 h might reduce the rate of complications

Inter-center comparison of EasyTube and endotracheal tube during general anesthesia in minor elective surgery - Fig 2

<p>Ventilation leakage of the EzT (A) and the ETT (B) during general anesthesia. Dashed line represents overall mean. Dotted line represents zero.</p

Surgical procedures with the use of EasyTube (EzT) or endotracheal tube (ETT).

<p>Surgical procedures with the use of EasyTube (EzT) or endotracheal tube (ETT).</p

Insertion time, duration of ventilation, number of insertion attempts, and insertion difficulty with the EasyTube (EzT) or endotracheal tube (ETT) in comparison between the sites.

<p>Insertion time, duration of ventilation, number of insertion attempts, and insertion difficulty with the EasyTube (EzT) or endotracheal tube (ETT) in comparison between the sites.</p

Complications during general anesthesia with the EasyTube (EzT) or endotracheal tube (ETT) in comparison between the sites.

<p>Complications during general anesthesia with the EasyTube (EzT) or endotracheal tube (ETT) in comparison between the sites.</p

Complications during general anesthesia with the EasyTube (EzT) or endotracheal tube (ETT) in comparison within the sites and in between the sites.

<p>Complications during general anesthesia with the EasyTube (EzT) or endotracheal tube (ETT) in comparison within the sites and in between the sites.</p