Real time dynamic ultrasound guided endotracheal intubation: A future foreseen

Abstract

Background The dynamic use of ultrasound for tracheal intubation is yet to be explored. The study reports the successful use of real time sonography for tracheal intubation in a cohort of 30 patients undergoing laparoscopic cholecystectomy under general anaesthesia. Aim To assess the feasibility of ultrasound guided intubation (UGTI) and to define the methodology to be deployed for performing ultrasound guided intubation (UGTI). Methods In this prospective study we included a cohort of 30 patients undergoing laparoscopic cholecystectomy under general anaesthesia. We used the real time ultrasound image to determine the hockey stick angulation of tube, corresponding to the angle seen on ultrasound between oral and laryngotracheal axis in slight head extension in supine position and then dynamic ultrasound guidance was used to advance the endotracheal tube through glottis. Results We were able to perform endotracheal intubation successfully in 76.6% patients with an average intubation time of 94.69 ± 24.7 seconds. Conclusion This study defines the probable methodology, to be used while performing ultrasound guided intubation. Also, UGTI can prove to be a minimally invasive real time infallible and fool proof technique for endotracheal intubation over traditional laryngoscopy.