JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (12)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sugiyama, K.
Right arrow Articles by Yoshitomi, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sugiyama, K.
Right arrow Articles by Yoshitomi, T.
Anesth Analg 1999;88:1380
© 1999 International Anesthesia Research Society

GENERAL ARTICLES

Does the Murphy Eye Reduce the Reliability of Chest Auscultation in Detecting Endobronchial Intubation?

Kazuna Sugiyama, DDS, PhD, Kozo Yokoyama, DDS, PhD, Ken-ichi Satoh, DDS, PhD, Masahiro Nishihara, DDS, and Tatsushi Yoshitomi, DDS

Department of Anesthesia, Kagoshima University Dental Hospital, Kagoshima, Japan

Address correspondence and reprint requests to Kazuna Sugiyama, DDS, PhD, Department of Anesthesia, Kagoshima University Dental Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan. Address e-mail to sugi{at}dentc.hal.kagoshima-u.ac.jp

Bilateral breath sounds are routinely auscultated after endotracheal intubation to verify that the endotracheal tube (ETT) tip is properly positioned. We conducted the present study to ascertain whether the eye of the Murphy tube has an influence on the reliability of auscultation of breath sounds in detecting endobronchial intubation. Twenty patients undergoing scheduled oral and maxillofacial surgery participated in this study. After the induction of general anesthesia, either the Magill tube or the Murphy tube was inserted through the nose into the trachea. The fiberoptic bronchoscope was inserted through the ETT, and the distance from the nares to the carina of the trachea was measured. When breath sounds from the left side of the chest changed and disappeared while the ETT was being advanced, the distance from the nares to the ETT tip was measured. Unilateral auscultatory change was not observed until the ETT tip was advanced beyond the carina and inserted 1.5 ± 0.4 cm into the right mainstem bronchus when the Magill tube was used and 2.0 ± 0.4 cm when the Murphy tube was used (P < 0.01). Breath sounds disappeared when the ETT tip was further advanced up to 3.2 ± 0.3 cm from the carina. We demonstrated that the eye of the Murphy tube reduces the reliability of chest auscultation in detecting endobronchial intubation.

Implications: The Murphy eye was designed to allow ventilation of the lung when the bevel of the endotracheal tube is occluded. We demonstrated that the eye of the Murphy tube reduces the reliability of chest auscultation in detecting endobronchial intubation.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
B. Marciniak, P. Fayoux, A. Hebrard, R. Krivosic-Horber, T. Engelhardt, and B. Bissonnette
Airway Management in Children: Ultrasonography Assessment of Tracheal Intubation in Real Time?
Anesth. Analg., February 1, 2009; 108(2): 461 - 465.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S.-Y. Yoo, J.-H. Kim, S.-H. Han, and A.-Y. Oh
A Comparative Study of Endotracheal Tube Positioning Methods in Children: Safety from Neck Movement
Anesth. Analg., September 1, 2007; 105(3): 620 - 625.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Gucev, D. T. Raphael, S. Elspas, and G. Glass
Pediatric Airway and Esophageal Profiles with Acoustic Reflectometry
Anesth. Analg., November 1, 2006; 103(5): 1126 - 1130.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. T. Verghese, R. S. Hannallah, M. C. Slack, R. R. Cross, and K. M. Patel
Auscultation of Bilateral Breath Sounds Does Not Rule Out Endobronchial Intubation in Children
Anesth. Analg., July 1, 2004; 99(1): 56 - 58.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1999 by the International Anesthesia Research Society.