Re-intubation frequency in paediatric surgical patients: a randomised controlled trial

Background: Paediatric tracheal intubation represents a challenge to many anaesthesiologists and requires considerable expertise. We assessed re-intubation frequency and the time needed for intubation in children undergoing elective surgical operations. Methods: A prospective randomised single blinded study was conducted in Mansoura University Children's Hospital, Egypt from April 2016 till April 2017. We enrolled 50 children scheduled for elective surgery not exceeding 90 minutes with general anaesthesia using an uncuffed endotracheal tube. They were randomly allocated into one of two groups (age-based group versus ultrasound based group). Primary outcome variables were re-intubation frequency and the time taken for intubation. Secondary outcome variables were optimum tube selection and complications after extubation. Results: In the ultrasound-based group, the frequency of re-intubation frequency was decreased due to an endotracheal tube which was too large (p = 0.047). The optimum tube selection was higher (p = 0.034) and the time taken for intubation was longer (p = 0.004). A significant correlation was found between the outer diameter of the endotracheal tube and the transverse diameter of the subglottic airway (r = 0.988, p 0.001). No significant differences were detected between groups regarding complications after extubation (p 0.05). Conclusion: Ultrasonography was superior to the use of an age-based formula in reducing re-intubation frequency but intubation was slower.