A New Technique to Reduce Epistaxis and Enhance Navigability During Nasotracheal Intubation

Seo, Kwang-Suk; Kim, Jae‐Hun; Yang, Sol Mon; Bahk, Jae Hyon; Yum, Kwang Won

doi:10.1213/01.ane.0000281156.64133.bd

Cited by 60 publications

(49 citation statements)

References 14 publications

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“…Currently, thermosoftening [15], the use of vasoconstrictors [6,16] and lubrication are widely used to reduce nasal bleeding following nasotracheal intubation. Several strategies have also been suggested to prevent epistaxis during nasotracheal intubation, including obturation of the tracheal tube [17], and using a nasopharyngeal airway [18] or a red rubber catheter [19] as a guide. The use of an oesophageal stethoscope-obturated tracheal tube was effective in preventing epistaxis associated with nasotracheal intubation by obturating the Murphy-tipped tracheal tube [17].…”

Section: Discussionmentioning

confidence: 99%

“…Several strategies have also been suggested to prevent epistaxis during nasotracheal intubation, including obturation of the tracheal tube [17], and using a nasopharyngeal airway [18] or a red rubber catheter [19] as a guide. The use of an oesophageal stethoscope-obturated tracheal tube was effective in preventing epistaxis associated with nasotracheal intubation by obturating the Murphy-tipped tracheal tube [17]. In Enk et al's study [18], the investigators inserted the tip of the tracheal tube into the trailing end of a red rubber nasopharyngeal airway and the tube was advanced under visual control to the oropharynx, guided by the airway.…”

Section: Discussionmentioning

confidence: 99%

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The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial

et al. 2014

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SummaryDuring nasotracheal intubation, the tracheal tube passes through either the upper or lower pathway in the nasal cavity, and it has been reported to be safer that the tracheal tube passes though the lower pathway, just below the inferior turbinate. We evaluated the use of a nasogastric tube as a guide to facilitate tracheal tube passage through the lower pathway, compared with the ‘conventional’ technique (blind insertion of the tracheal tube into the nasal cavity). A total of 60 adult patients undergoing oral and maxillofacial surgery were included in the study. In 20 out of 30 patients (66.7%) with the nasogastric tube‐guided technique, the tracheal tube passed through the lower pathway, compared with 8 out of 30 patients (26.7%) with the ‘conventional’ technique (p = 0.004). Use of the nasogastric tube‐guided technique reduced the incidence and severity of epistaxis (p = 0.027), improved navigability (p = 0.034) and required fewer manipulations (p = 0.001) than the ‘conventional’ technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial

et al. 2014

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“…In two studies, authors describe a decreased incidence of pain reported by adult patients postoperatively following nasal intubation using a pathfinder technique for NTI [17] [18]. Future recommendations would be to conduct postoperative assessments in the pediatric population to correlate findings.…”

Section: Summary Of the Literaturementioning

confidence: 99%

“…Vansickle, and Ouanes presented three case reports in which an endotracheal tube introducer or bougie was used to facilitate successful and atraumaticnasal intubation using a Seldinger technique [18]. The authors discussed how the use of a nasal bougie can guide tubes through narrow nasal passages and small pharyngeal spaces without transoral manipulation [19].…”

Section: Summary Of the Literaturementioning

confidence: 99%

“…The authors discussed how the use of a nasal bougie can guide tubes through narrow nasal passages and small pharyngeal spaces without transoral manipulation [19]. The use of an esophageal stethoscope for NTI also proved to be effective as well in reducing epistaxis and reducing trauma in a randomized control study from Seoul University School of Dentistry [18].…”

Section: Summary Of the Literaturementioning

confidence: 99%

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A Safer Technique for Nasal Intubation: A Literature Review

Lera¹,

Machan²,

Derefaka³

2017

OJAnes

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Nasotracheal intubation (NTI) is the most widely used method to establish an airway during anesthesia for oral surgery. It has the advantage of providing exceptional accessibility and optimal working conditions in the oral cavity for surgeons. Anesthesia providers are highly trained in managing and securing the airway. Because the oral intubation route is the most widely used technique for securing the airway, nasal intubation can be cumbersome for anesthetists who do not routinely perform this skill. Moreover, anesthesia providers who do not routinely perform NTI may feel apprehension out of concern for nasopharyngeal bleeding and trauma. The number of dental and oromaxillofacial procedures requiring nasal intubation has been steadily growing annually. Although NTI is generally safe, it still presents a risk for complications. The purpose of this literature review was to examine current literature and evidence-based practices of NTI to determine whether the use of a catheter-guided technique will improve patient care outcomes by way of decreased trauma to the airway compared to current clinical practices. The goal of this review is to recommend the use of a catheter-guided technique for NTI as the preferred method for securing the airway during oral surgery as it is less traumatizing to the airway than conventional methods.

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The Pediatric Airway in Neurosurgery

Morrison

Kain

2011

Essentials of Neurosurgical Anesthesia &Amp; Critical Care

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A New Technique to Reduce Epistaxis and Enhance Navigability During Nasotracheal Intubation

Abstract: The use of esophageal stethoscope-obturated ETTs was effective, and comparable to thermosoftening, in preventing epistaxis associated with nasotracheal intubation. Thermosoftened, obturated ETTs were more effective than simple thermosoftened ETTs in reducing epistaxis.

Cited by 60 publications

References 14 publications

The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial

The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial

A Safer Technique for Nasal Intubation: A Literature Review

The Pediatric Airway in Neurosurgery

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