ArticleJournal of anaesthesiology, clinical pharmacology
Comparison of lateral and cephalad direction of bevel on the path taken by tracheal tube during nasotracheal intubation: A randomized trial.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: There are two anatomical pathways in the nasal cavity through which the endotracheal tube may pass during nasotracheal intubation: the lower pathway and upper pathway. The upper pathway lies above the inferior turbinate, just below the middle turbinate. The lower pathway lies along the floor of the nose, underneath the inferior turbinate. The lower pathway is considered a safer route due to the lesser risk of epistaxis, as it is located away from the middle turbinate. However, we cannot select the lower pathway exclusively, as there are no clear indicators to differentiate between the upper and lower pathways blindly. The direction of the bevel of the tube may guide the pathway taken by the tracheal tube during nasotracheal intubation. Material and Methods: Sixty patients, aged 18 to 60 years, with American Society of Anaesthesiologist (ASA) physical status I or II, scheduled for elective surgery under general anesthesia requiring nasotracheal intubation, were included in this study. In Group I (n = 30), the tracheal tube was inserted with the bevel in a lateral direction (conventional group), and in Group II (n = 30), the tracheal tube was inserted with the bevel in a cephalad direction (interventional group). The primary objective was to determine the path followed by the tracheal tube through the nasal cavity during nasotracheal intubation. Results: In Group I, the tracheal tube passed through the lower pathway in 15 patients (50%) and through the upper pathway in 15 patients (50%). In Group II, the tracheal tube passed through the lower pathway in 24 patients (80%) and through the upper pathway in 6 patients (20%) ( Conclusion: The results of the present study reveal that the cephalad bevel of the reinforced tracheal tube significantly favors the lower pathway compared to the lateral bevel during nasotracheal intubation.
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