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| LETTER TO THE EDITOR |
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| Year : 2011 | Volume
: 27
| Issue : 4 | Page : 574-575 |
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Endotracheal tube fixation in neurosurgical procedures operated in prone position
Georgene Singh, Sethuraman Manikandan, Praveen Kumar Neema
Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| Date of Web Publication | 24-Oct-2011 |
Correspondence Address:
Praveen Kumar Neema
Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9185.86621
How to cite this article:
Singh G, Manikandan S, Neema PK. Endotracheal tube fixation in neurosurgical procedures operated in prone position. J Anaesthesiol Clin Pharmacol 2011;27:574-5 |
How to cite this URL:
Singh G, Manikandan S, Neema PK. Endotracheal tube fixation in neurosurgical procedures operated in prone position. J Anaesthesiol Clin Pharmacol [serial online] 2011 [cited 2021 Mar 4];27:574-5. Available from: https://www.joacp.org/text.asp?2011/27/4/574/86621 |
Sir,
Neurosurgical procedures operated in the prone position carry risk of endotracheal tube (ETT) dislodgement, which is potentially life threatening. [1] The soiling of the adhesive tape used for the ETT fixing and the weight of the breathing circuit can loosen the adhesive plasters,which can result in ETT slippage and dislodgement. Methods to secure ETT for the patients operated in prone position include its suturing, [2],[3] and placing transparent adhesive dressing over the plasters and face. [4] Several ETT fixation devices have been described. [5] We describe a simple method of ETT fixation for the neurosurgical patients operated in prone position. Initially, the ETT is fixed with elastic adhesive tapes in conventional manner. Thereafter, another adhesive tape (approximately 50 cm long and 1.5 cm wide) is taped like a sling around the occiput (for cervical spine and cervicomedullary junction procedures) or around the neck (for posterior-fossa procedures and occipital craniectomies), with the ends wrapped around the ETT and then onto the upper or lower lip in opposite direction. The adhesive tape is just taped and not applied tightly. To prevent soiling, the adhesive tapes are covered with transparent adhesive drapes [Figure 1]a and b. We have used this method in 35 neurosurgical procedures operated in prone position. In the later 20 patients, ultrasonography performed after application of adhesive tapes ruled out compromise of lumen of both the internal jugular veins. During surgery, the operating surgeon neither complained of venous congestion or excessive oozing in any patient, nor did we notice excessive oozing. We believe that with this method of ETT fixation, the ETT is well-secured and there is no possibility of its dislodgement. | Figure 1: (a) ETT fixation for cervical spine and cervicomedullary junction procedures with elastic adhesive-tape encircling occiput; (b) ETT fixation for posterior-fossa procedures and occipital craniectomies with elastic adhesive-tape encircling neck
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 References | |  |
| 1. | Kramer DC, Lo JC, Gilad R, Jenkins A. Fiberoptic scope as a rescue device in ananesthetized patient in the prone position. Anesth Analg 2007;105:890. 
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| 2. | Gupta D, Agarwal A, Sahu S, Singh PK. A novel method of nasotracheal tube fixation in pediatric patients undergoing neurosurgical procedure in the prone position. Anesth Analg 2007;104:462-3.
[PUBMED] [FULLTEXT] |
| 3. | Bhat VR, Venkateshwaran G. A secure method of nasotracheal tube fixation using an infant feeding tube. Anesth Analg 2004;99:1352- 4.
[PUBMED] [FULLTEXT] |
| 4. | Mikawa K, Maekawa N, Goto R, Yaku H, Obara H. Transparent dressing is useful for the secure fixation of the endotracheal tube. Anesthesiology 1991;75:1123-4.
[PUBMED] [FULLTEXT] |
| 5. | Murdoch E, Holdgate A. A comparison of tape-tying versus a tube-holding device for securing endotracheal tubes in adults. Anaesth Intensive Care 2007;35:730-5.
[PUBMED] |
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