Clinical trial NCT03102255: The Effect of 'Sniffing Position & Nasal Tip Lifting' in Nasotracheal Intubation
Official title: The Effect of 'Sniffing Position & Nasal Tip Lifting' on the Pathway of Tracheal Tube in Nasal Cavity During Nasotracheal Intubation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Intubation Complication
Keywords: Nasotracheal intubation
Lead sponsor: Seoul National University Hospital
Sponsor class: OTHER
First posted: 2017-04-05
Enrollment: 86
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The goal of this prospective randomized study is to compare the effect of nasal tip lifting during nasotracheal intubation.

The question the investigators are trying to answer is: If the nasal tip is tilted, will the E-tube be more likely to enter the lower passage during nasal intubation?

Detailed description: There are three nasal turbinates inside the nasal cavities. Each nasal cavity is divided into four spaces from these nasal turbinates, but the two spaces separated by the upper nasal turbinate are too narrow to be clinically meaningful. So when performing nasotracheal intubation, the tube enters one of the two spaces in low part divided into the lower turbinate. The middle turbinate, unlike others, a large number of blood vessels and nerves are distributed. Therefore, less hemorrhage might occurs when the tracheal tube enters into the lower pathway below the lower turbinate because the tube would not scratching the middle turbinate.

The hypothesis of this study is that the method 'sniffing position and nasal tip lifting' increases possibility to enter into lower pathway when the tube enters the nasal cavity. The purpose of a present study was to investigate the effect of 'sniffing position \& nose' on the intranasal route of the tube.

Eligibility criteria: Inclusion Criteria:

* The patients who need to nasotracheal intubation for surgery.

Exclusion Criteria:

* Who doesn't agree to enroll.
* Who has severe nasal deformities.
* Who has a problem to make sniffing position or nasal tip lifting
* Who has severe nasal bleeding history.

Primary outcomes:
measure: Number of patients with nasal endotraheal tube in the lowest nasal pathway.
timeFrame: Through study completion, an average of 1 year
Secondary outcomes:
measure: Nasal bleeding
timeFrame: Through study completion, an average of 1 year
measure: Intubation time
timeFrame: Through study completion, an average of 1 year
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: Seoul National University Boramae Hospital
Study officials:
affiliation: Seoul National University Boramae Hospital
name: Jung-Man Lee, M.D.,PhD
role: STUDY_DIRECTOR
References:
citation: Ahmed-Nusrath A, Tong JL, Smith JE. Pathways through the nose for nasal intubation: a comparison of three endotracheal tubes. Br J Anaesth. 2008 Feb;100(2):269-74. doi: 10.1093/bja/aem350. Epub 2007 Dec 14.
citation: Patiar S, Ho EC, Herdman RC. Partial middle turbinectomy by nasotracheal intubation. Ear Nose Throat J. 2006 Jun;85(6):380, 382-3.
citation: Williams AR, Burt N, Warren T. Accidental middle turbinectomy: a complication of nasal intubation. Anesthesiology. 1999 Jun;90(6):1782-4. doi: 10.1097/00000542-199906000-00039. No abstract available.
citation: Dost P, Armbruster W. Nasal turbinate dislocation caused by nasotracheal intubation. Acta Anaesthesiol Scand. 1997 Jun;41(6):795-6. doi: 10.1111/j.1399-6576.1997.tb04787.x.
citation: Scamman FL, Babin RW. An unusual complication of nasotracheal intubation. Anesthesiology. 1983 Oct;59(4):352-3. doi: 10.1097/00000542-198310000-00016. No abstract available.
citation: Kim H, Lee JM, Lee J, Hwang JY, Chang JE, No HJ, Won D, Choi S, Min SW. Influence of Nasal Tip Lifting on the Incidence of the Tracheal Tube Pathway Passing Through the Nostril During Nasotracheal Intubation: A Randomized Controlled Trial. Anesth Analg. 2018 Dec;127(6):1421-1426. doi: 10.1213/ANE.0000000000003673.