The Effect of Bevel Direction on the Pathway of the Nasotracheal Tube

Study Overview
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Brief Summary
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In this study, the subjects are divided into two groups (group I: intervention group = the nasotracheal tube inserted with the bevel of the nasal tube facing the direction of the patient's head, and Group II: conventional group = the bevel of the tube toward the left side of the subject). After the endotracheal tube is introduced, a flexible endoscope is used to evaluate whether the tube is located below the inferior turbinate, i.e. in the lower pathway.

Detailed Description
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Primary outcome incidence of tracheal tube passing through the lower pathway (beneath the inferior turbinate and immediately above the nasal floor of the nostril) Secondary outcome intubation time incidence of epistaxis severity of bleeding Resistance during Insertion of the tracheal tube

Official Title
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The Effect of Bevel Direction on the Pathway of the Tracheal Tube in the Nasal Cavity During Nasotracheal Intubation: a Randomized Controlled Trial

Conditions
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Epistaxis, Intubation Complication

Intervention / Treatment
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* Procedure: Bevel facing the cephalad direction of the patient
* Procedure: Bevel facing leftward of the patient


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a patient who will take operation which needs nasotracheal intubation under general anesthesia Exclusion Criteria: a patient who didn't agree to participate in this study a patient who has a deformity of the nose a patient who has a history of severe epistaxis a patient who has coagulation problem a patient who has a history of the fracture or surgery of the skull base

Ages Eligible for Study
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Minimum Age: 18 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: intervention group<br>In the intervention group, a nasotracheal tube is inserted into the nostril with the bevel of the tube facing the cephalad direction of the patient. | Procedure: Bevel facing the cephalad direction of the patient<br>* The bevel of the nasotracheal tube facing cephalad direction of the patient<br>|
| Active Comparator: conventional group<br>In the conventional group, a nasotracheal tube is inserted in a usual way, i.e., with the bevel of the tube facing the left side of the patient. | Procedure: Bevel facing leftward of the patient<br>* The bevel of the nasotracheal tube facing the left side of the patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of the tube in lower pathway | incidence of tracheal tube passing through the lower pathway (beneath the inferior turbinate and immediately above the nasal floor of the nostril) | right after completion of the intubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intubation time | time to complete endotracheal intubation | from the start of the intubation to the completion of the intubation, which is confirmed by the appearance of end-tidal CO2 curve, up to 60 seconds | 
| incidence and severity of epistaxis | incidence and severity of epistaxis | right after completion of the intubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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epistaxis