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Korean Journal of Anesthesiology 1991;24(2):379-383.
DOI: https://doi.org/10.4097/kjae.1991.24.2.379   
" TOTI " Method for Difficult Orotracheal Intubation in Adult Patients.
Ik Sang Seung
Department of Anesthesiology, College of Medicine, Han Yang University, Seoul, Korea.
Abstract
This report is a prospective study comparing conventional direct laryngoseopy with tube-over-tube intubation ("TOTI") method in 42 male patients, whose tracheas were difficult to intubate. ("TOTI") method using two different-sized endotracheal tubes, the newly devised technique has not been mentioned yet. And the comparative studies have not been performed to evaluate relative efficacy, speed, or incidence of complications for the conventional versus "TOTI" method in endotracheal intubation. Overall number of attempts (mean+/-SE) in conventional group was 3.62+/-0.37(range; 1-8), while "TOTI" one was 1.1+/-0.07 (range; 1-2). The time required for intubation ranged from 25 to 64 seconds in TOTI group and 37 to 2015 sec in conventional one, average (mean+/-SE) 37.19+/-1.87 and 542.71+/-111.54sec, respectively. No complications of endotracheal intubation occured in "TOTI" group, whereas in coventional one there occurred fourteen patients with sore throat, seven with hoarseness and five with temporary short-lived dysrhythmia.
Key Words: INTUBATION; difficult; conventional laryngoscopy; "TOTI" method; ANESTHE- SIA; general; COMPLICATIONS; hoarseness; dysrhythmia; sore throat


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