Flexometallic versus RAE Endotracheal Tube in Cleft Lip and Palate Surgery

  • Jyoti M. Naitam Department of Anaesthesiology, Government Medical College, Nagpur, Maharashtra 440003
  • N. G. Tirpude Department of Anaesthesiology, Government Medical College, Nagpur, Maharashtra 440003
Keywords: Flexo-metallic tube, RAE tube, Cleft lip or palate surgery, Intraoperative issues, Airway management


Aim and Objectives: The present study was carried out with an objective to evaluate ease of insertion of catheter and suctioning through Flexo-metallic tube versus Ring Adair Elwin (RAE) tube, to know the incidence of kinking of RAE tube and to note down the endo-bronchial placement of Flexo-metallic versus RAE tube and surgeon’s comfort zone.

Methods: A prospective observational randomized study was conducted on 60 ASA grade I and II pediatric patients of age group 4 month to 16 years undergoing cleft lip and palate surgeries. Patients were randomly allocated in two groups of 30 each. Group R: intubated with RAE South pole tube and group F: intubated with flexo-metallic tube. The ease of insertion of suction catheter, ease of suctioning of secretions, refixation required, kinking of tracheal tube, incidence of displacement, airway complications and surgeons’ feedback- Comfort zone were noted.

Results: The ease of suctioning through lumen of Tracheal tube was easier in group ‘F’ as compared to RAE tube. No kinking of tracheal tube was found in any group. The displacement of tracheal tube was observed in 2 patients in group ‘R’. Refixation of tracheal tube was required in 2 patients in group ‘R’. Bronchospasm and cough was noted in 1 patient in group ‘R’. No variations in vitals (e.g. blood pressure and heart rate) were observed in any group. Surgical team was comfortable in both groups but more so with Flexo-metallic tracheal tube group. On extubation we found retained secretions at distal portion of RAE tube in 2 patients.

Conclusion: Flexometallic tracheal tube provides advantage of easy suctioning of tracheal secretions. Do not kink in mouth gag of surgical field, provides better airway security and stability, less intra-operative manipulation by anaesthetist, less airway complications, provides better surgical field.


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