A new technique to reduce epistaxis and enhance navigability during nasotracheal intubation.
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).


CONCLUSIONS
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.
Seo
Kwang Suk
KS
Department of Dental Anesthesiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.
Kim
Jae-Hun
JH
Yang
Sol Mon
SM
Kim
Hyun Jeong
HJ
Bahk
Jae-Hyon
JH
Yum
Kwang Won
KW
D000328:Adult; D004844:Epistaxis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000502:physiology; D019023:Stethoscopes