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Nasotracheal tube placement over the fibreoptic laryngoscope
Author(s) -
HUGHES S.,
SMITH J. E.
Publication year - 1996
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1996.tb14996.x
Subject(s) - clockwise , medicine , nasotracheal intubation , tube (container) , surgery , intubation , tracheal tube , rotation (mathematics) , anesthesia , mathematics , materials science , geometry , composite material
Summary We have assessed the effectiveness of three tracheal tube rotational movements in assisting nasotracheal tube placement over the fibreoptic laryngoscope. Ninety ASA grade 1 or 2 oral surgery patients undergoing fibreoptic nasotracheal intubation under general anaesthesia were studied. After the fibrescope had been positioned in the trachea, patients were randomly allocated to one of three groups. In group 1, no rotation was used and the tube was advanced towards the trachea in the neutral position. In group 2, the tube was rotated by 90° anticlockwise. In group 3, the tube was rotated by 180° anticlockwise, then rotated back to 90° anticlockwise (overcorrected rotation). If resistance to the advance was encountered, up to two more attempts were allowed, after further rotational manoeuvres had been made, in accordance with a standard, graduated sequence. There were significantly more successful tube placements at the first attempt in groups 2 and 3 (93% and 100% respectively) than in group I (63%). It is therefore recommended that 90° anticlockwise or overcorrected 90° anticlockwise tube rotation is used to facilitate nasotracheal tube placement during fibreoptic intubation.