คำสำคัญ:NASOTRACHEAL INTUBATION, GUIDING CATHETER, EPISTAXIS
DOES SUCTION TUBE GUIDING REDUCE EPISTAXIS FROM NASOTRACHEAL INTUBATION?
Isara Jongcharoenkamon MD., Tanatorn Juajarn MD., Nipawan Pisilp RN.
Department of Anesthesiology, Maharatnakhonrajasima hospital
Background: Epistaxis is a common complication of nasotracheal intubation that lead to more difficult to proceed intubation. Guiding catheter pass nasopharynx can reduce false tract and impingement of nasopharynx area that lead to epistaxis. Suction tube is an equipment that we always prepare for intubation, so no more cost needed to use it as the catheter tube.
Methods: A Randomized controlled trial study, compare nasotracheal intubation with suction tube guiding to conventional technique (blind insertion of tracheal tube through nasal cavity), primary outcome is incidence of epistaxis. secondary outcomes are grade of epistaxis, difficulty of nasopharynx insertion and numbers of attempt. Statistically significant was calculated by Fisher exact test
Results: 70 patients who need nasotracheal intubation to proceed the operation were randomized into two groups (suction guiding group and conventional group; 35 patients each). The incidence of epistaxis is no difference between suction guiding group and conventional group 11(31.43%) VS 16(45.71%)
(Risk ratio 0.68; 0.37-1.26). There was no severe bleeding in suction guiding group (0 VS 2). Difficulty score and number of attempts were statistically different between suction guiding group and conventional group; P-value=0.002 and 0.0473 consequencely.
Conclusion: Suction guiding nasotracheal intubation does not reduce the incidence of epistaxis but there was no severe bleeding in suction guiding group. It was easier in passing tracheal tube through nasopharynx by use suction tube guiding to perform nasotracheal intubation.
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