Tube Rotation for Tube Passage Into the Oral Cavity in Nasotracheal Intubation

NCT06618625 — Not applicable, Unknown, 80 participants, Seoul National University Hospital

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The Effect of Tube Rotation on Passage of Tracheal Tube Through Nasopharynx Into the Oral Cavity in Nasotracheal Intubation

RegistryNCT06618625
StatusUnknown
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: double, prevention
Enrollment80 (Estimated)
SponsorSeoul National University Hospital (Other); collaborators: SMG-SNU Boramae Medical Center
ConditionsNasotracheal Intubation
Interventionsnasotracheal intubation (Procedure)
Datesstart 2024-09-23 (estimated), primary completion 2025-08-22 (estimated), completion 2025-09-22 (estimated), first posted 2024-10-01, last updated 2024-10-01

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-Summary

The purpose of the study is to investigate the effect of tube rotation on passage of the tracheal tube through the nasopharynx into the oral cavity in nasotracheal intubation.

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+Detailed description

This prospective randomized controlled study was approved by IRB of our institute.

Patients requiring nasotracheal intubation will be screened for eligibility of the study. Then, patients will be randomized to one of two groups; (group I: tube advancement in neutral / group II: tube advancement with the tube counter-clockwise rotated). After induction of anesthesia and muscle relaxation, the preformed nasal RAE (Ring-Adair-Elwyn) tube will be inserted via a nostril approximately 3-4 cm. Next, an anesthesiologist will advance the tube, with it neutral, continuously into the oral cavity of the patients in Group I, while the anesthesiologist will advance the tube, with it rotated counter-clockwise in 90 degree, into the oral cavity of the patients in Group II. After the tube will be placed in the oral cavity, the anesthesiologist will perform nasotracheal intubation with Magill forceps. After that, an investigator will check occurrence of epistaxis due to nasotracheal intubation and its severity with a fiberoptic bronchoscope. After obtainment of all data, investigators will analyze incidence of epistaxis and its severity between two groups.

+Arms and interventions

ArmTypeInterventionsDescription
RotationExperimentalProcedure: nasotracheal intubationFor nasotracheal intubation, the nasal RAE tube will be inserted with it rotated by 90 degrees in counter-clockwise direction for patients in the 'Rotation' arm.
NeutralActive comparatorProcedure: nasotracheal intubationFor nasotracheal intubation, the nasal RAE tube will be inserted without tube rotation for patients in the 'Neutral' arm.
  • nasotracheal intubation (Procedure): For nasotracheal intubation, the nasal RAE tube will be inserted with it rotated by 90 degrees in counter-clockwise direction for patients in the 'Rotation' arm. For nasotracheal intubation, the nasal RAE tube will be inserted without tube rotation for patients in the 'Neutral' arm.

+Outcome measures

Primary outcomes

  • tube blockade [during tube advancement from the nasal cavity to the oral cavity]: tube blockade when an anesthesiologist is advancing the tracheal tube from the nasal cavity to the oral cavity.

Secondary outcomes

  • epistaxis [during nasotracheal intubation]: epistaxis due to nasotracheal intubation

+Eligibility

Sex: All, ages: 19 Years to any

Inclusion Criteria:

* adult patients requiring nasotracheal intubation for elective surgery

Exclusion Criteria:

* refuse to participate in the study
* severe deformity in nose
* current severe epistaxis
* limitation of neck extension

+Publications

  • Kim H, Lee JM, Lee J, Hwang JY, Chang JE, No HJ, Won D, Row HS, Min SW. Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial. BMC Anesthesiol. 2019 Aug 17;19(1):158. doi: 10.1186/s12871-019-0831-6. PMID 31421677