A randomized comparison of the prone ventilation endotracheal tube versus the traditional endotracheal tube in adult patients undergoing prone position surgery

Abstract

Endotracheal tube displacement or dislocation is a severe complication that can occur in patients who require prone position ventilation. We hypothesized the prone position tube (PPT) would reduce the incidence of displacement of an endotracheal tube in an adult prone operation compared to a traditional tube (TT). A total of 80 adult patients undergoing neurosurgery or spine surgery were recruited. Sixty patients with prone position ventilation were randomly divided into the traditional routine endotracheal tube group (Group TT, n = 30) and the prone position ventilation endotracheal tube group (Group PPT, n = 30). The primary outcome measures were the incidence of the endotracheal tube displacement during surgery, and the secondary outcomes were symptoms of sore throat, dysphagia and dysphonia during follow-up in the post-anesthesia care unit (PACU). The incidence of tube displacement was significantly lower in the PPT group (0 [0%] of 30 patients) compared to the TT group (22 [73.3%] of 30 patients; odds ratio [OR] 0.73, 95% CI 0.591-0.910; P = 0.005). There was no statistical difference in sore throat, dysphagia and vocal function between the two groups (P > 0.05) during follow-up. Compared to the traditional tube, the improved prone positon tube reduced the incidence of displacement of the endotracheal tube. This study was registered with ClinicalTrials.gov on April 29, 2015 (No. NCT02449356).

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1

Photograph showing the traditional tube used in an operation (A) and the prone position tube used in an operation (B). The prone position tube (PPT) and the traditional tube (TT) (C). With a highlighted image of the prone position tube (PPT) (D).

Figure 2

Trial flow diagram.