MAGNETIC OROTRACHEAL INTUBATION - A NEW TECHNIQUE

We sought to determine the effectiveness of a magnet placed over the t hyroid cartilage in the neck to guide an endotracheal tube into the tr achea. Forty patients aged 18 to 60 yr with normal airway anatomy (ASA grade I) who required general anesthesia with an endotracheal tube an d paralysis for their surgery were chosen and informed consents were o btained. The tip of the epiglottis was exposed with a No. 3 MacIntosh laryngoscope, and a magnet was held over the thyroid cartilage. A cath eter with stylet was placed behind the epiglottis allowing the magnet to pull the stylet and catheter close to the glottic opening. The cath eter was advanced into the trachea over the stylet and its position wa s confirmed by auscultating the lungs and by capnography. An extension tube was connected to the catheter, and the endotracheal tube was gui ded into the trachea over the catheter. The tracheas of 37 patients we re intubated on the first attempt with the magnet. The tracheas of the remaining three patients could not be intubated on the first attempt but were successfully intubated without complications on the second at tempt. An additional five patients with an anterior larynx whose trach eas could not be intubated with direct laryngoscopy also had tracheal intubation with a magnet. This magnet-guided technique can be used whe n it is difficult to expose a patient's larynx. It is noninvasive, sim ple, and can be used without any delay when expensive flexible fiberop tic endoscopes are not readily available, The procedure takes an avera ge of 1 to 2 min.