Shivaji Keerthana, Mulimani Sridevi, S D Deepa, Suntan Anusha
Anesthesiology, Shri BM Patil Medical College and Hospital, BLDE University, Vijayapura, IND.
Cureus. 2023 Mar 1;15(3):e35642. doi: 10.7759/cureus.35642. eCollection 2023 Mar.
Introduction End-tidal capnography (EtCO) has been the gold standard method for confirmation of endotracheal intubation. Upper airway ultrasonography (USG) is a new promising method for confirming endotracheal tube (ETT) placement and has the potential to become the first-line non-invasive airway assessment tool in the future thanks to widespread POCUS knowledge, greater technology improvements, portability, and availability of ultrasound in the majority of essential areas. Hence our study aimed to compare upper airway USG and EtCO for the confirmation of ETT placement in patients undergoing general anesthesia. Aim To compare the upper airway USG with EtCO for confirmation of ETT placement in patients requiring general anesthesia for elective surgical procedures. The objectives of the study were to compare the time taken for confirmation, and the number of correct identification of tracheal and esophageal intubation by both upper airway USG and EtCO. Materials and methods After obtaining institutional ethical committee (IEC) approval, a prospective randomized comparative study involving 150 patients under American Society of Anesthesiologists (ASA) grade I and II requiring endotracheal intubation for elective surgeries under general anesthesia was randomized into two groups, Group U-upper airway USG and Group E-EtCOwith 75 patients in each group. ETT placement confirmation was done by upper airway USG in Group U and by EtCOin Group E and the time taken for confirmation of ETT placement and correct identification of esophageal and tracheal intubation by USG and EtCOwas noted. Results The demographic details among both groups were statistically insignificant. Upper airway USG had a faster average confirmation time of 16.41 seconds when compared to EtCO which took an average confirmation time of 23.56 seconds. In our study, upper airway USG was able to identify esophageal intubation with 100% specificity. Conclusion Upper airway USG can be a reliable method and can be employed as a standard method for confirmation of ETT location in patients undergoing elective surgeries under general anesthesia when compared to EtCO.
引言
呼气末二氧化碳监测（EtCO）一直是确认气管插管的金标准方法。上气道超声检查（USG）是一种用于确认气管导管（ETT）位置的新的有前景的方法，由于床旁超声（POCUS）知识的广泛普及、技术的更大改进、便携性以及超声在大多数关键区域的可用性，它有可能在未来成为一线非侵入性气道评估工具。因此，我们的研究旨在比较上气道USG和EtCO在全身麻醉患者中确认ETT位置的情况。
目的
比较上气道USG和EtCO在需要全身麻醉进行择期手术的患者中确认ETT位置的情况。本研究的目的是比较确认所需的时间，以及上气道USG和EtCO对气管插管和食管插管的正确识别数量。
材料和方法
在获得机构伦理委员会（IEC）批准后，一项前瞻性随机对照研究纳入了150例美国麻醉医师协会（ASA）I级和II级、需要在全身麻醉下进行择期手术气管插管的患者，随机分为两组，U组——上气道USG组和E组——EtCO组，每组75例患者。U组通过上气道USG确认ETT位置，E组通过EtCO确认，记录确认ETT位置所需的时间以及USG和EtCO对食管插管和气管插管的正确识别情况。
结果
两组之间的人口统计学细节无统计学差异。与平均确认时间为23.56秒的EtCO相比，上气道USG的平均确认时间更快，为16.41秒。在我们的研究中，上气道USG能够以100%的特异性识别食管插管。
结论
与EtCO相比，上气道USG可以是一种可靠的方法，并且可以用作在全身麻醉下进行择期手术的患者中确认ETT位置的标准方法。
