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Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial

BACKGROUND/AIM: Nasotracheal Airtraq is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. MATERIALS AND METHODS: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, betwe...

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Autores principales: ARSLAN, Zehra İpek, TÜRKYILMAZ, Neşe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Scientific and Technological Research Council of Turkey 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350855/
https://www.ncbi.nlm.nih.gov/pubmed/30762320
http://dx.doi.org/10.3906/sag-1803-177
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author ARSLAN, Zehra İpek
TÜRKYILMAZ, Neşe
author_facet ARSLAN, Zehra İpek
TÜRKYILMAZ, Neşe
author_sort ARSLAN, Zehra İpek
collection PubMed
description BACKGROUND/AIM: Nasotracheal Airtraq is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. MATERIALS AND METHODS: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18 and 70 years of age undergoing elective maxillofascial, oral, and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomized into the right and left nostril groups. RESULTS: Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (P < 0.001). 90° counterclockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (P < 0.001 vs P = 0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. CONCLUSION: Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90° counterclockwise rotation, external laryngeal pressure, and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand, cuff inflation maneuver must also be kept in mind.
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spelling pubmed-73508552020-07-13 Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial ARSLAN, Zehra İpek TÜRKYILMAZ, Neşe Turk J Med Sci Article BACKGROUND/AIM: Nasotracheal Airtraq is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. MATERIALS AND METHODS: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18 and 70 years of age undergoing elective maxillofascial, oral, and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomized into the right and left nostril groups. RESULTS: Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (P < 0.001). 90° counterclockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (P < 0.001 vs P = 0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. CONCLUSION: Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90° counterclockwise rotation, external laryngeal pressure, and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand, cuff inflation maneuver must also be kept in mind. The Scientific and Technological Research Council of Turkey 2019-02-11 /pmc/articles/PMC7350855/ /pubmed/30762320 http://dx.doi.org/10.3906/sag-1803-177 Text en Copyright © 2019 The Author(s) This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Article
ARSLAN, Zehra İpek
TÜRKYILMAZ, Neşe
Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial
title Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial
title_full Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial
title_fullStr Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial
title_full_unstemmed Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial
title_short Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial
title_sort which nostril should be used for nasotracheal intubation with airtraq nt®: the right or left? a randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350855/
https://www.ncbi.nlm.nih.gov/pubmed/30762320
http://dx.doi.org/10.3906/sag-1803-177
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