Nasal Bleeding, Nasotracheal Intubation
Conditions
Keywords
Nasotracheal Intubation
Brief summary
The purpose of this study is to determine whether nasal intubation over a bougie placed via a nasal trumpet will decrease nasal trauma when compared to the conventional technique of blind nasal endotracheal tube passage.
Detailed description
Conventional nasotracheal intubation techniques (or Conventional Videolaryngoscopic Techniques, CVT) are known to be associated with significant trauma to the patient's nares and the endotracheal tube itself. The investigators propose an alternative technique (Nasotracheal intubation over a bougie placed via a subsequently removed nasal trumpet, or NIB) which involves using Seldinger technique over a bougie placed via a nasal trumpet which promises to not only be less traumatic to the patient and the endotracheal tube, but also to take less time to perform and have a higher first-attempt success rate than conventional methods. The investigators propose a randomized prospective interventional study comparing this new technique with conventional technique to see if a significant difference exists.
Interventions
PROCEDURENasotracheal intubation over a bougie
Nasotracheal intubation over a bougie, placed with videolaryngoscopy assistance, via a nasopharyngeal airway with or without the aid of Magill forceps
PROCEDUREConventional Nasotracheal Intubation
Blind passage of an endotracheal tube via the nare followed by videolaryngoscopy-assisted passage through the glottis, with or without the aid of Magill forceps
Sponsors
University of Iowa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
8 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients scheduled for elective surgery with an anesthetic plan including asleep nasotracheal intubation
Exclusion criteria
* Patients needing emergent airway protection * Patients undergoing emergency surgery * Patients whom are known to be pregnant * Patients whom are currently anticoagulated (including daily aspirin use) * Patients whose anesthetic includes the use of nitrous oxide * Patients whom are currently incarcerated * Patients 7 years of age or younger * Mentally incompetent adults * Patients whom refuse involvement in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nasal trauma | 60-90 seconds post-intubation | Bleeding noted on nasopharyngeal exam by surgical resident |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Nasal trauma | 5 minutes post-intubation | Bleeding noted on nasopharyngeal exam by surgical resident |
| Time to intubation | Measured immediately post-intubation | Time from first entrance of ETT or bougie into the nare to the presence of end-tidal CO2 via nasotracheal ETT |
| First attempt success rate | Measured immediately post-intubation | Whether or not there was successful nasotracheal intubation on the first attempt |
| Need for Magill forceps | Measured Immediately post-intubation | Whether or not Magill forceps were used during airway management |
Countries
United States
Outcome results
None listed