Comparison of warming and without warming endotracheal tube in facility and complication rates in Blind nasotracheal intubation in general anesthesia in maxillofacial surgeries

Abstract

Introduction The aim of this study was to compare outcomes of blind Nasotracheal intubation methods with and without warming of endotracheal tube. Blind nasotracheal intubation clinically is A method of intubation without Observation of glottis that is used when the orotracheal intubation is difficult or impossible. According to previous studies, the warming endotracheal tube is a good practice because it increases the flexibility of the tube when passes through the high curvature of nasopharynx, and the result will be less trauma. This study want to answer this question that does warming tracheal tube in Blind nasotracheal intubation for apneic and anesthetized patients increase the success rate of this method And how it will affect the rate of intubation complications. Materials and Methods 60 patients for this study were considered that were divided into two Randomized 30 patients groups. In both groups Was used a similar Blind nasotracheal intubation method , With this difference that in one group Intubation tube is warm and the other group is not warm. Spss version 16 will be used for analysis of the data. Descriptive statistics (frequency, percentage, mean and standard deviation) will be used to describe the data. T-test will be used for comparison the intubation time and success rate, HR, MBP and SaO2. Chi-squre will be used To compare the number of attempts, epistaxis, sore throat and laryngospasm. T-test for age and weight and Chi-squre will be used for ASA, type of surgery, Associated Disease and sex. Repeated measured T-test method is used FOR Changes will be measured repeatedly during the procedure, such as HR, MBP and SaO2 . Results Results showed that there was no significant difference between demographic data. In terms of gender, considering that most patients had maxillofacial trauma and this trauma is higher in men so this difference was significant. Mean arterial pressure, heart rate and arterial oxygen saturation before and after general anesthesia, before and after intubation were statistically significant, but lack clinical value. Blind nasotracheal intubation success rate in the control group was 70% and in the study group was 83.3%. Although the success rate in the study group was higher than the control group, but this difference was not statistically significant. Epistaxis rate in the control group was 66.3% and the in the study group was 33.3%, which is significant. On the other hand the severity of epistaxis in the study group was significantly lower than the control group. Conclusions We conclude that softening the tracheal tube with warm water in nasotracheal intubation significantly reduces the rate and intensity of epistaxis but not increased intubation facility and success rate of nasotracheal intubation.