Blind nasotracheal intubation is facilitated by neutral head position and endotracheal tube cuff inflation in spontaneously breathing patients

Chung, Yung-Tai; Sun, Maw-Sheng; Wu, Hung-Shan

doi:10.1007/bf03021066

Cited by 27 publications

(20 citation statements)

References 13 publications

(11 reference statements)

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“…Furthermore, the Trachway stylet tip can be positioned proximal to the side hole of the nasotracheal tube in order that its softened tip prevents the stylet from damaging surrounding tissues. Trachway-assisted nasotracheal intubation easily facilitates tube tip advancement into the trachea by its levering effect and does not require accessory tools such as Magill forceps [18] or cuff inflation [7]. The scope-first technique that we used for fibreoptic intubation was superior to a tube-first technique because tube advancement through the nasopharynx prevents the insertion cord tip from being misplaced into the Murphy eye of the tracheal tube [19].…”

Section: Discussionmentioning

confidence: 99%

“…Use of a fibreoptic intubation technique is considered the 'gold standard' for difficult laryngoscopy [2]; however, the flexible portion of the fibrescope is easily damaged, expensive to repair and this in turn may lead to a decrease in its routine use [3,4]. Although a lightwand-guided nasotracheal intubation technique has been developed [5][6][7][8], this blind technique may cause tissue damage and is not useful if illumination is sub-optimal, for example in the obese or patients with short necks [9].…”

Section: Introductionmentioning

confidence: 99%

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Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway^®

et al. 2015

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SummaryIn patients with limited mouth opening, traditional laryngoscopy and videolaryngoscopes are not useful when performing nasotracheal intubation. Eighty patients with limited mouth opening who required nasotracheal intubation were randomly assigned to either fibreoptic intubation (n = 40) or the Trachway â (n = 40). Using the modified nasal intubation difficulty scale, 22 (55%) patients who received fibreoptic intubation were categorised as no difficulty compared with 40 (100%) patients in the Trachway group (p < 0.001). Mean (SD) total intubation time was 71.8 (23.3) s in patients who received fibreoptic intubation compared with 35.4 (9.8) s in the Trachway group (p < 0.001). We conclude that the Trachway technique for nasotracheal intubation is quicker and easier compared with fibreoptic intubation in patients with limited mouth opening.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway^®

et al. 2015

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“…This technique of cuff inflation has been described for blind nasal intubation in spontaneously breathing patients. 5,6 In our cases, muscle relaxation was given to facilitate videolaryngoscopy. Videolaryngoscopy might have been difficult in spontaneously breathing patients unless they were deeply anaesthetized.…”

Section: Discussionmentioning

confidence: 97%

Cuff inflation to aid nasotracheal intubation using the C-mac videolaryngoscope

Baddoo¹,

Phillips²

2011

Ghana Medical Journal

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SUMMARYA preliminary report is presented of a technique for using the C-MAC videolaryngoscope to carry out nasopharyngeal intubations. The main thrust of the technique is that cuff inflation of the endotracheal tube is used to lift the endotracheal tube off the posterior pharyngeal wall and thus direct it towards the glottis. The technique was used successfully in 5 consecutive patients needing nasotracheal intubation. Indeed a couple of these patients might have been difficult to intubate using conventional laryngoscopy. The full technique is described together with pictures at the various stages of intubation.

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“…Several mechanical aids have been used to facilitate blind nasotracheal intubation including suction catheters, nasogastric tubes, flexible lighted stylets, metallic stylets, nasopharyngeal airways and tracheal tubes [1][2][3][4][5][14][15][16][17][18]. Although the use of gum elastic bougie has been described as an aid in nasotracheal intubation, laryngoscopy has often been used to guide its advancement [19,20].…”

Section: Discussionmentioning

confidence: 99%

Use of a gum elastic bougie to facilitate blind nasotracheal intubation in children: a series of three cases

2006

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SummaryManagement of a difficult paediatric airway is challenging, and the unavailability of a paediatric fibreoptic bronchoscope, a common limitation in developing countries, adds to these difficulties. Children with bilateral temporomandibular joint ankylosis have limited mouth opening and therefore direct laryngoscopy and intubation is not usually possible. In the absence of sophisticated fibreoptic equipment, blind nasal intubation remains the only non-surgical option for control of the airway. Blind nasal intubation in paediatric anaesthesia is difficult. We describe a novel method of blind nasal intubation in paediatric patients using a gum elastic bougie. We have used this method successfully in three patients in whom tracheal intubation using a conventional blind nasal approach was unsuccessful. In view of its reliability and the absence of any soft tissue injury, we propose the use of this novel technique as an alternative to conventional blind nasal intubation, when more sophisticated fibreoptic equipment is not available.

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Blind nasotracheal intubation is facilitated by neutral head position and endotracheal tube cuff inflation in spontaneously breathing patients

Cited by 27 publications

References 13 publications

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway^®

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway^®

Cuff inflation to aid nasotracheal intubation using the C-mac videolaryngoscope

Use of a gum elastic bougie to facilitate blind nasotracheal intubation in children: a series of three cases

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Blind nasotracheal intubation is facilitated by neutral head position and endotracheal tube cuff inflation in spontaneously breathing patients

Cited by 27 publications

References 13 publications

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway®

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway®

Cuff inflation to aid nasotracheal intubation using the C-mac videolaryngoscope

Use of a gum elastic bougie to facilitate blind nasotracheal intubation in children: a series of three cases

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Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway^®

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway^®