Guidewire Use in Nasotracheal Intubation
Condition: Epistaxis Nosebleed; Pharyngeal Bleeding
MeSH terms: Epistaxis; Hemorrhage
Study type: Interventional

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.
    

Intervention name(s): Nasotracheal intubation with conventionally; Nasotracheal intubation with angled ETT using guidewire
Intervention type(s): Device; Device
Intervention description(s): Nasotracheal intubation will be applied conventionally to patients in this group.; 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.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Diagnostic
Keywords: Airway management; Intubation complication; Nasotracheal intubation; Nasal bleeding