Abstract:
Abstract
Introduction
End-tidal capnography (EtCO2) 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 EtCO2 for the confirmation of ETT placement in patients undergoing general anesthesia.
Aim
To compare the upper airway USG with EtCO 2 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 EtCO2.
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-EtCO2 with 75 patients in each group. ETT placement confirmation
was done by upper airway USG in Group U and by EtCO2 in Group E and the time taken for confirmation of
ETT placement and correct identification of esophageal and tracheal intubation by USG and EtCO2 was
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 EtCO2 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 EtCO2.
