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A randomized comparison of three intubation techniques/tube materials for nasotracheal intubation

Authors
 Jiwon Lee  ;  Jung-Man Lee  ;  Yon Hee Shim  ;  Joung Goo Cho  ;  Jimin Lee  ;  Jae-Yol Lim  ;  Chul Ho Chang 
Citation
 CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, Vol.71(7) : 978-986, 2024-07 
Journal Title
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
ISSN
 0832-610X 
Issue Date
2024-07
MeSH
Adult ; Aged ; Anesthesia, General* / methods ; Epistaxis* / etiology ; Female ; Humans ; Intubation, Intratracheal* / instrumentation ; Intubation, Intratracheal* / methods ; Male ; Middle Aged ; Mouth ; Nasal Cavity ; Polyvinyl Chloride ; Time Factors
Abstract
Purpose: We sought to compare three intubation methods using different intubation techniques/tube materials for tube advancement from the nasal cavity into the oral cavity during nasotracheal intubation.

Methods: We conducted a randomized clinical trial with adult patients scheduled to undergo elective surgery requiring nasotracheal intubation for general anesthesia. Participants were randomly allocated to a polyvinyl chloride (PVC) tube group (group P), PVC tube attached to a rubber catheter group (group PR), or velvet-soft PVC tube group (group V). Tracheal intubation was then performed based on group allocation. The primary outcome was the first-attempt success rate of tube advancement into the oral cavity; secondary outcomes included the time required for tube advancement into the oral cavity, total intubation time, and the incidence of epistaxis.

Results: A total of 149 patients were included in the study. The first-attempt success rate in group V (90%) was significantly higher than that in group P (58%) (odds ratio, 6.5; 95% confidence interval [CI], 2.2 to 19.2), but similar to that in group PR (100%). The mean (standard deviation) time required for tube advancement into the oral cavity was significantly shorter in group V (16 [13] sec) than in group PR [40 (10) sec; 95% CI of mean difference, 17 to 30] and group P (26 [16] sec; 95% CI of mean difference, 3 to 16). Total intubation time was longest in group PR. Epistaxis occurred the least in group V.

Conclusions: Among the three intubation techniques/tube materials for nasotracheal intubation, the velvet-soft PVC tube provided the highest first-attempt success rate, most expeditious advancement into the oral cavity, and lowest incidence of epistaxis.
Full Text
https://link.springer.com/article/10.1007/s12630-024-02743-z
DOI
38548948
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Lee, Jiwon(이지원)
Lim, Jae Yol(임재열) ORCID logo https://orcid.org/0000-0002-9757-6414
Chang, Chul Ho(장철호) ORCID logo https://orcid.org/0000-0001-5647-8298
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200349
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