Epistaxis Nosebleed, Pharyngeal Bleeding
Conditions
Keywords
Airway management, Intubation complication, Nasotracheal intubation, Nasal bleeding
Brief summary
During nasotracheal intubation, nasopharyngeal trauma and associated bleeding may occur. The investigators think that some of this bleeding is due to trauma to the posterior wall of the nasopharynx. The investigators designed this study, thinking that if nasopharyngeal posterior wall trauma can be prevented, some of these bleedings can be prevented.
Detailed description
Nasotracheal intubation (NTI) is a frequently used airway management method in pedodontic dental treatments performed under general anesthesia. However, nasopharyngeal trauma and associated bleeding are common during conventional NTI. In this study, the investigators aimed to examine the effect of angling the end of the endotracheal tube (ETT) by placing a guide wire inside the ETT on nasopharyngeal bleeding. The patients included in the study were randomized into two groups. In the control group (Group C), NTI will be done conventionally. In the study group (Group S), a guide wire will be inserted into the ETT before intubation and angled 100-120 degrees to the distal end (in the shape of a hockey stick). The angulation will not be sharp but slightly curved and the apex of the angulation will be 2.5-3 cm proximal from the distal end. The ETT will be positioned perpendicular to the face and inserted into the nostril. After the angled part of the ETT passes through the nostrils, it will be directed to caudally according to the angle given to the tip of the ETT. Meanwhile, the ETT will be moved as a whole to prevent the ETT tip from contacting the posterior wall of the nasopharynx. When the ETT tip reaches the oropharynx, the guidewire will be removed and the rest of the intubation will be completed as in the conventional method.
Interventions
DEVICENasotracheal intubation with conventionally
Nasotracheal intubation will be applied conventionally to patients in this group.
DEVICENasotracheal intubation with angled ETT using guidewire
a guide wire will be inserted into the ETT before intubation and angled 100-120 degrees to the distal end (in the shape of a hockey stick). The angulation will not be sharp but slightly curved and the apex of the angulation will be 2.5-3 cm proximal from the distal end. The ETT will be positioned perpendicular to the face and inserted into the nostril. After the angled part of the ETT passes through the nostrils, it will be directed to caudally according to the angle given to the tip of the ETT. Meanwhile, the ETT will be moved as a whole to prevent the ETT tip from contacting the posterior wall of the nasopharynx. When the ETT tip reaches the oropharynx, the guidewire will be removed and the rest of the intubation will be completed as in the conventional method.
Sponsors
Bezmialem Vakif University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Masking description
After intubation was completed, bleeding was evaluated by the other investigator who did not know the patient's group.
Eligibility
Sex/Gender
ALL
Age
2 Years to 12 Years
Healthy volunteers
Yes
Inclusion criteria
* 2-12 years old * American Society of Anesthesiologists I-III * Patients with elective dental surgery * Patients whose parents have accepted informed consent forms * Patients without previous nasopharyngeal anomalies * Patients without previous nasopharyngeal surgeries * Patients without upper airway infections
Exclusion criteria
* Under 2 or over 12 years old * Emergency surgeries * Patients whose parents have not accepted informed consent forms * Patients with previous nasopharyngeal anomalies * Patients with previous nasopharyngeal surgeries * Patients with upper airway infections
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of blood in oropharynx or on the endotracheal tube | In the first minute after intubation | The presence of blood in the oropharynx or endotracheal tube will be defined by assessing it on a scale. (0 = no blood, 2 = mild, that is, dye-like blood on the endotracheal tube, 3 = severe, that is, obvious blood in the oropharynx). |
Countries
Turkey (Türkiye)
Outcome results
None listed