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GENERAL ARTICLES

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

Kwang Suk Seo, MD^*, Jae-Hun Kim, MD, Sol Mon Yang, MD, Hyun Jeong Kim, MD^*, Jae-Hyon Bahk, MD, and Kwang Won Yum, MD^*

From the *Department of Dental Anesthesiology and Dental Research Institute, Seoul National University School of Dentistry, and Department of Anesthesiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Dr. Jae-Hyon Bahk, Department of Anesthesiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong Jongno-gu, Seoul, Korea 110-744. Address e-mail to bahkjh{at}plaza.snu.ac.kr.

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.

This article has been cited by other articles:

				J. L. Tong and L. S. Malanjum Reducing Epistaxis During Nasotracheal Intubation Anesth. Analg., June 1, 2008; 106(6): 1923 - 1924. [Full Text] [PDF]

				J.-H. Bahk and K. S. Seo Reducing Epistaxis During Nasotracheal Intubation Anesth. Analg., June 1, 2008; 106(6): 1924 - 1924. [Full Text] [PDF]

				Does a Warm Tube Improve Nasotracheal Intubation? Journal Watch Emergency Medicine, November 30, 2007; 2007(1130): 4 - 4. [Full Text]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999