“Two-hand-manoeuver” during nasotracheal intubation

et al. 2019

BMC Anesthesiol

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 the 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 ‘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. Trial registration ClinicalTrials.gov Identifier NCT03377114 , registered on 13 December 2017.

Section: Discussionmentioning

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

et al. 2019

BMC Anesthesiol

“…Our study demonstrated that neck extension during advancing a tracheal tube from the nasal cavity into the oropharyngeal space could assist in smooth passage of the tube. For successful nasotracheal intubation, some previous studies have focused on tube impingement and solutions [12][13][14][15]. However, these previous studies mentioned impingement at the hypopharyngeal and laryngeal space but not at the naso/oro-pharyngeal space in fiberoptic intubation.…”

Section: Discussionmentioning

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

et al. 2019

Preprint

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.

Section: Discussionmentioning

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

et al. 2019

Preprint

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.