Efficacy of ultrasound in confirmation of Endotracheal Intubation and position in adult patients undergoing general anaesthesia: a cross-sectional study

Endotracheal intubation is a fundamental component of airway management in both elective surgeries and emergency care. Ensuring correct placement of the endotracheal tube (ETT) is essential, as malposition can lead to severe complications. An optimal ETT placement should ensure sufficient distance (2-5 cm) between the tip of the ETT and the carina. Upper airway ultrasonography being used in real time during intubation to detect tracheal placement by the loss of “snowstorm sign” and to assess ETT depth using a saline-filled cuff technique. The ultrasound of saline-filled cuff technique is a rapid and reliable method, involves no radiation, requires no patient positioning, and can be done as many times as needed.

This study will be a prospective observational clinical trial to assess the efficacy of ultrasound in confirmation of endotracheal tube intubation and confirmation of endotracheal tube position in adult patients undergoing general anaesthesia. After approval from the Research Ethics Board of RIMS, Imphal, a total number of 51 patients (18-60 years, ASA I and II, Mallampati class I and II) will be enrolled after taking written informed consent from the patients. Endotracheal intubation will be performed under suitable conditions. With upper airway ultrasound, confirmation of the endotracheal intubation using linear probe (4-12 Hz) in real time during intubation by detecting loss of snow storm sign and double trachea sign will be done. After confirmation of endotracheal intubation 10 ml of normal saline will be infused into the cuff and proximal end of the saline filled cuff of the endotracheal tube will be fixed at T3in neutral head and neck position. Tip to carina distance will be measured using flexible fiberoptic bronchoscope.

Presence or absence of Snow storm sign, Double trachea sign, Wave capnography, tip to Carina distance will be observed as outcomes. Data will be recorded will be analyzed using SPSS V.26.0 (Chicago, Illinois, USA)software. Apvalue of < 0.05 will be considered statistically significant.