A Reliable Method of Securing The Endotracheal Tube in Patients Undergoing Neurosurgical Procedure in the Prone Position

Background: Unplanned endotracheal tube dislodgement in the prone position can be catastrophic. Even after a perfect intubation, disconnection between the connector and the tube has been known to occur. It is on this background that we sought a reliable method of ensuring that the endotracheal tube remains in the intended position.Method: This was a prospective study done over a 4 year period. Following routine oro or nasotracheal intubation, the endotracheal tube connector was secured with an adhesive tape to the tube itself. The integrity of the connection was assessed physically and monitored throughout the course of the anaesthetic.Results: Of the 385 patients managed in this way, there was no incident of inadvertent extubation (100%).Conclusion: We conclude that securing the tube to the connector successfully prevents inadvertent extubation in the prone position. We advice that this technique be adopted in hospitals without a protocol for securing the endotracheal tube in this position.

---