A prospective, randomised, cross-over trial comparing the EndoFlex and standard tracheal tubes in patients with predicted easy intubation.

We aimed to determine if using the EndoFlex tracheal tube on the first intubation attempt provided improved placement times and intubation success compared with a standard-type tracheal tube in 50 patients undergoing gynaecological surgery in a prospective, randomised, cross-over trial. We found that using the EndoFlex resulted in shorter intubation times (mean (SD) 14.8 (9.7) vs 30.1 (30.5) s), easier intubation (VAS, median (range) 10 (0-70) vs 20 (0-100)), and an increased rate of successful insertion at the first attempt; all p < 0.001. Flexing the distal tip of the EndoFlex was used in 18 patients. There were reductions in the use of external laryngeal pressure, advancement of laryngoscope blade and increased lifting force when intubating with the EndoFlex. Furthermore, patients with a grade 2 (19/50) or 3 (6/50) laryngoscopic view had shorter intubation times, easier intubation and reduced insertion attempts with the EndoFlex. The EndoFlex is a satisfactory alternative to a standard-type tracheal tube, even with an anterior larynx.