Comparison of Different Tools to Facilitate Nasotracheal Tube Placement Under Video-laryngoscope Use

Study Overview
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Brief Summary
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to investigate the effectiveness of techniques of either using Magill forceps or cuff inflation in facilitation of nasotracheal tube advancement into trachea

Detailed Description
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Patients who undergo oxo-maxillofacial surgery need naso-tracheal intubation to present good surgical view-field. but, sometimes, the naso-tracheal tube is unable to advance from nasopharynx, oropharynx, into trachea without assistance. Using techniques of either Magill forceps or cuff inflation is advantageous is not determined.

Official Title
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Comparison Techniques of Magill Forceps and Cuff Inflation to Facilitate Nasotracheal Tube Placement Under Video-laryngoscope Use

Conditions
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Nasotracheal Intubation

Intervention / Treatment
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* Procedure: Magill forceps
* Procedure: cuff inflation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with American Society of Anesthesiologists physical status I-III aged 20-65 years Requiring Nasotracheal Intubation under general anesthesia unlimited mouth open unlimited neck motion Exclusion Criteria: mouth open < 3 cm Ankylosing arthritis patients. BMI≧35 kg/m2

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Magill forceps<br>experimental Magill forceps group: Magill forceps technique to facilitate nasotracheal tube advancement into trachea | Procedure: Magill forceps<br>* Magill forceps techniques to facilitate nasotracheal tube advancement into trachea<br>|
| Experimental: cuff inflation<br>experimental cuff inflation group: cuff inflation technique to facilitate nasotracheal tube advancement into trachea | Procedure: cuff inflation<br>* cuff inflation techniques to facilitate nasotracheal tube advancement into trachea<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the technique spending time in this time interval and first attempt successful rate | to measure the time taken of either using Magill forceps or with cuff inflation techniques in successfully intubated patients | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total intubation time taken | measure the whole intubation time taken from tube tip into selected nostril, to nasopharynx, to oropharynx, into trachea, till capnography showing of 3 consecutive CO2 waveforms | half an hour | 
| glottic injury and cuff damages during tube advanced | to assess the bleeding point of glottic area and the cuff injury of endotracheal tube | half an hour | 
| postoperative nasal bleeding, sore throat and hoarseness | Events of intubating related nasal bleeding were measured on selected nostril and oral cavity at 3 minutes post-intubation. Incidences of sore throat and hoarseness are evaluated before patients out of recovery room and the coming morning | 2 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Magill forceps, cuff inflation, Nasotracheal Intubation