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Bite-block tube for airway-management during electroconvulsive therapy.

During electroconvulsive therapy, an oropharyngeal tube (e.g. Guedel airway) is often used for maintenance of the upper airway after the induction of anaesthesia and this is often replaced with a bite-block for protection of the teeth during convulsions (1,2). It may be necessary to re-insert the oropharyngeal tube again after the convulsions have ceased. While the oropharyngeal tube serves well for lifting the tongue from the posterior pharyngeal wall, the pressure exerted by the grinding or clenching of teeth on the comparatively small flange during convulsions potentially endangers both the jaw and the teeth (3). For this reason, we would like to draw your attention to a method of combining an oropharyngeal airway and a bite-block into a 'bite-block tube' (Figure 1). The bite-block tube can be inserted in the same way as a Guedel airway. A bite-block tube can be constructed by creating a central perforation in a soft rubber bite-block by enlarging the dorsal slit. This perforation can accommodate a Guedel airway. A similar principle can be used protect endotracheal tubes in intubated patients. The combined oropharyngeal tube with biteblock may help maintain the airway and protect teeth during ECT, thus enhancing patient safety.




Innsbruck, Austria


(1.) Gaines GY, Rees DI. Electroconvulsive therapy and anesthetic considerations. Anesth Analg 1986; 65:1345-1356.

(2.) Selvin BL. Electroconvulsive therapy. Anesthesiology 1987; 67:367-385.

(3.) King HK, Lewis K. Guedel oropharyngeal airway does not prevent patient biting on the endotracheal tube. Anaesth Intensive Care 1996; 24:729-730.
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Title Annotation:Correspondence
Author:Lederer, W.; Kinzl, J.F.
Publication:Anaesthesia and Intensive Care
Article Type:Brief article
Geographic Code:4EUAU
Date:Aug 1, 2007
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