Nasotracheal intubation under curve-tipped suction catheter guidance reduces epistaxis

Abstract

Nasotracheal intubation under CTSC guidance increases the success rate of airway instrumentation, and also reduces the incidence and severity of epistaxis.

Analysis of clinical characteristics, dental treatment performed, and postoperative complications of 200 patients treated under general anesthesia in a special needs dental clinic in northern Taiwan

“…Methods to reduce nasal bleeding rate including warming endotracheal tubes, 6 Xylometazoline pretreatment, 7 using the right nostril as the first choice, 8 and using a curved tip catheter as guidance. 9 As it is impossible to totally avoid epistaxis, the nasotracheal intubation should be avoided in patients who have bleeding tendencies.…”

Case report: Nasotracheal intubation — look before leaping to assess the laryngeal view

“…A common complication of nasotracheal intubation is epistaxis, with a reported incidence of 15-80%, depending on a variety of factors including vasoconstrictor drug application to nasal passage, type and size of nasotracheal tube, use of heat-softened tube, and patient characteristics. [3][4][5][6][7][8][9] Because epistaxis can interfere with visualization of the oropharynx and thus impede intubation, a recommendation 2 has been made to assess the airway by direct laryngoscopy prior to passing an endotracheal tube through the nares. If confronted by a potentially difficult airway (Cormack Lehane grade > 2), the airway may be initially secured orally without being impeded by blood in the hypopharynx secondary to epistaxis.…”

Retropharyngeal dissection during nasotracheal intubation: a rare complication and its management

“…Thermo-softening treatment of a nasotracheal tube with warm saline before intubation effectively reduces epistaxis and nasal damage [19,20]. A recent study showed that use of a curve-tipped suction catheter to guide nasotracheal intubation resulted in increased success as well as a substantial decrease in the frequency and severity of epistaxis [21]. Choosing the right nostril for nasotracheal intubation when patency appears equal on both sides of the nose has been suggested [22].…”