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

2007; Lippincott Williams & Wilkins; Volume: 105; Issue: 5 Linguagem: Inglês

10.1213/01.ane.0000281156.64133.bd

1526-7598

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

Foreign Body Medical Cases

In Brief BACKGROUND: Epistaxis is the most common complication of nasotracheal intubation. We compared endotracheal tubes (ETT) obturated with an inflated esophageal stethoscope with normal ETTs with regard to the prevention of epistaxis and navigability, both with and without thermosoftening. METHODS: Dental surgical patients requiring nasotracheal intubation were randomly allocated into 1 of 4 groups (n = 50 each): Group 1, nonthermosoftened ETTs; Group 2, nonthermosoftened ETTs obturated with an inflated esophageal stethoscope; Group 3, thermosoftened ETTs; and Group 4, thermosoftened ETTs obturated with an inflated esophageal stethoscope. Navigability of ETTs through the nasal cavity and postintubation epistaxis were evaluated. RESULTS: Navigability of ETTs through the nasal cavity was the worst in Group 1 (P = 0.001). Epistaxis was the most severe in Group 1, similar between Groups 2 and 3, and the least severe in Group 4 (P < 0.001). CONCLUSION: 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. IMPLICATIONS: Esophageal stethoscope-obturated endotracheal tubes were comparable to thermosoftened endotracheal tubes in preventing the nasal trauma associated with nasotracheal intubation.