Neck Movement Implicate the Tracheal Tube-tip Displacement in Pediatric Surgery
Neck Movement Implicate the Tracheal Tube-tip Displacement in Pediatric Surgery
This study evaluates the effect of head and neck movement in children on endotracheal tube
 (ETT) tip displacement undergoing head-and-neck surgeries. The tube-tip displacement will be
 measured using flexible fiberoptic bronchoscope.
In clinical application, especially in head-and-neck surgeries, the operators often change
 the position of children's head-neck for easy operating. Flexing the head resulted in the ETT
 moving towards the carina, and extension resulted in the tube being displaced in the opposite
 direction. Head and neck movement change the length of trachea as well: extending the head
 resulted in the extension of trachea, while flexing resulted in the opposite. Serious
 complications following from head and neck movement, such as accidental extubation and
 endobronchial intubation, threat children's life.

 In pediatric anesthesia, insertion depth (cm) of orotracheal intubation equals to age/2+12,
 according to classic intubation formulae. The ETT will be put in the depth calculated by the
 classic formulae under general anesthesia. The distance of ETT-tip displacement and the
 length change of trachea will be measured as the head and neck placed as follows: fully
 extended, neutral position, or fully flexed. These three head and neck positions imitate the
 head-neck movement during those head-and-neck surgeries.
Inclusion Criteria:

 -  subject has elective head-and-neck surgery schedule

 -  subject will have orotracheal intubation under general anesthesia

 Exclusion Criteria:

 -  subject has malformations of the trachea or bronchus on chest X-ray

 -  subject has spinal deformity

 -  subject has difficulties in neck flexion or extension

 -  subject has neck pain