Influence of Nasal Tip Lifting on the Incidence of the Tracheal Tube Pathway Passing Through the Nostril During Nasotracheal Intubation: A Randomized Controlled Trial

Kim, Hye Rim; Lee, Jung Man; Lee, Jiwon; Hwang, Jin Young; Chang, Jong San; No, Hyun Joung; Won, Dong Hwan; Choi, Seung-Myung; Min, Sang Il

doi:10.1213/ane.0000000000003673

“…CI confidence interval a result, 72.3% of tubes passed the lower pathway in the nasal cavity. These results were similar to our previous data (78%) in the nasal tip lifting group [10]. Therefore, the results of our present study supported the results of our previous study.…”

Section: Discussionsupporting

confidence: 94%

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Kim

¹

,

Lee

²

,

Lee

³

et al. 2019

Preprint

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Background Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril, from the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to investigate the effect of neck extension on advancement of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation. Methods Patients were randomized to the ‘neck extension group (E group)’ or ‘neutral position group (N group)’ for this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the E group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patient’s neck extended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was successfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned group, the case was defined as to ‘success.’ We compared the success rate of tube advancement between the two groups. Results Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube passage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%; odds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002). Conclusion Neck extension during tube advancement from the nasal cavity to the oropharynx before laryngoscopy could be helpful in nasotracheal intubation.

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“…We compared the incidence of nasal bleeding between two groups with a χ 2 test. We assessed the incidence of tube passing pathway to verify results of our previous study [10]. We also assessed the intubation times between two groups with Student's t-test.…”

Section: Discussionmentioning

confidence: 98%

“…In case of blockage, the investigator measured the inserted length of the tube at the moment of blockage by using thread as in a previous study [11]. Following this measurement in the case of blockage, we attempted to advance the tube one more with the same maneuver after After completion of nasotracheal intubation, an investigator who was experienced in fiberoptic nasotracheal intubation and had not witnessed the intubation process inserted a fiberscope with an outer diameter of 4.1 mm (Olympus LE-P; Olympus Optical Co. Tokyo, Japan) into spaces above and below the tube through the nostril to identify whether the tube had passed through the upper pathway or the lower pathway [10]. The investigator checked the presence and grade of epistaxis or nasopharyngeal bleeding while also observing the nasal space with the bronchoscope and oropharynx with the laryngoscope.…”

Section: Methodsmentioning

confidence: 99%

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Kim

¹

,

Lee

²

,

Lee

³

et al. 2019

Preprint

Self Cite

0

View full text Add to dashboard Cite

Background Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril, from the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to investigate the effect of neck extension on advancement of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation. Methods Patients were randomized to the ‘neck extension group (E group)’ or ‘neutral position group (N group)’ for this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the E group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patient’s neck extended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was successfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned group, the case was defined as to ‘success.’ We compared the success rate of tube advancement between the two groups. Results Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube passage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%; odds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002). Conclusion Neck extension during tube advancement from the nasal cavity to the oropharynx before laryngoscopy could be helpful in nasotracheal intubation.

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“…After completion of nasotracheal intubation, an investigator who was experienced in fiberoptic nasotracheal intubation and had not witnessed the intubation process inserted a fiberscope with an outer diameter of 4.1 mm (Olympus LE-P; Olympus Optical Co. Tokyo, Japan) into spaces above and below the tube through the nostril to identify whether the tube had passed through the upper pathway or the lower pathway [10]. The investigator checked the presence and grade of epistaxis or nasopharyngeal bleeding while also observing the nasal space with the bronchoscope and oropharynx with the laryngoscope.…”

Section: Methodsmentioning

confidence: 99%

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Kim

¹

,

Lee

²

,

Lee

³

et al. 2019

Preprint

Self Cite

0

View full text Add to dashboard Cite

Background Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril, from the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to investigate the effect of neck extension on advancement of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation. Methods Patients were randomized to the ‘neck extension group (E group)’ or ‘neutral position group (N group)’ for this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the E group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patient’s neck extended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was successfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned group, the case was defined as to ‘success.’ We compared the success rate of tube advancement between the two groups. Results Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube passage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%; odds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002). Conclusion Neck extension during tube advancement from the nasal cavity to the oropharynx before laryngoscopy could be helpful in nasotracheal intubation.

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Influence of Nasal Tip Lifting on the Incidence of the Tracheal Tube Pathway Passing Through the Nostril During Nasotracheal Intubation: A Randomized Controlled Trial

Abstract: The nasal tip lifting maneuver helped to guide preformed nasal RAE tubes into the lower pathway during nasotracheal intubation.

Cited by 18 publications

References 23 publications

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

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