Inspection of the nasopharynx prior to fiberoptic-guided nasotracheal intubation reduces the risk epistaxis

Kwon, Min Soo; Song, Jaegyok; Kim, Seok-Kon; Ji, Seong-mi; Bae, Jeongho

doi:10.1016/j.jclinane.2015.12.016

Cited by 24 publications

(21 citation statements)

References 15 publications

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“…Secondly, only a paediatric bougie was used as a Seldinger nasotracheal intubation guide, which can be inadequate for guiding a large nasotracheal tube past the nasal cavity and glottis in adult patients. Do the authors concur with our experience, that the selection of a bougie size based on the patient's age can facilitate nasotracheal tube passage, decrease nasopharyngeal trauma and improve tube navigability, as effectively as fiberoptic bronchoscope‐guided nasotracheal intubation ?…”

mentioning

confidence: 51%

Comparing bougie‐guided and conventional nasotracheal intubations using videolaryngoscopy

2018

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mentioning

confidence: 51%

Comparing bougie‐guided and conventional nasotracheal intubations using videolaryngoscopy

2018

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“…Furthermore, performing NTI under suction catheter guidance represents a simple and effective method for smoothly introducing a nasal endotracheal tube and reducing nasal bleeding during NTI [9]. In other studies, the placement of a bougie through a nasopharyngeal airway also protected the nasal mucosa and helped guide the tracheal tube and was associated with less epistaxis as well as better navigability and a lower redirection rate [3,17]. In the present study, no moderate or severe epistaxis occurred in either group, perhaps for the following reasons: each nostril was pre-measured for size and patency by fibreoptic bronchoscopy, and five drops of 1% ephedrine solution were instilled into larger nasal cavities to prevent bleeding.…”

Section: Discussionmentioning

confidence: 96%

“…Nasotracheal intubation (NTI) is frequently used during oral and maxillofacial surgeries [1].Possible complications, especially epistaxis and trauma to the airway, can occur during NTI [2]. Fibreoptic bronchoscopy-guided NTI is associated with less epistaxis and better navigability and has a lower redirection rate [3]. In other studies, compared with the Macintosh laryngoscope, fibreoptic bronchoscopy-guide NTI resulted in a lower rate of sore throat and significantly shortened the total intubation time, and the McGrath MAC laryngoscope improved the field of view during intubation and shortened the intubation time [4,5].…”

Section: Introductionmentioning

confidence: 99%

A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

et al. 2019

Preprint

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Background: Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fibreoptic bronchoscopy. Methods: Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fibreoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time, which was deﬁned as the time from when the fibreoptic bronchoscope or aseptic suction catheter was inserted into the nasal cavity to the time at which the tracheal tube was correctly inserted through the glottis, was recorded. Epistaxis was recorded using direct laryngoscopy ﬁve minutes after completing NTI and was scored as one of four grades according to the following modiﬁed criteria: no epistaxis, mild epistaxis, moderate epistaxis, and severe epistaxis. Results: The time to complete NTI was significantly longer in the fibreoptic group than that in the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% confidence interval (CI), 10.4 to 18.1). In addition, mild epistaxis was observed in 8 patients in the fibreoptic group and in 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, no obvious nasal pain was reported at any time point after extubation in the two groups (P = 0.74). Conclusion: NTI can be completed successfully using either fibreoptic bronchoscopy or a Disposcope endoscope as a guide without any severe complications. However, compared to fibreoptic bronchoscopy, the Disposcope endoscope requires less execution time (the NTI time).

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“…Thus, it can decrease adverse effects of nasotracheal intubation such as epistaxis and make nasotracheal intubation easier by finding out the best nostril in the patient who may experience interruption of tube [10]. However, it takes long training time.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial suction catheter guided nasotracheal intubation with preformed nasotracheal tube

et al. 2020

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Inspection of the nasopharynx prior to fiberoptic-guided nasotracheal intubation reduces the risk epistaxis

Cited by 24 publications

References 15 publications

Comparing bougie‐guided and conventional nasotracheal intubations using videolaryngoscopy

Comparing bougie‐guided and conventional nasotracheal intubations using videolaryngoscopy

A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

Endobronchial suction catheter guided nasotracheal intubation with preformed nasotracheal tube

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