scholarly journals Effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation under direct laryngoscopy: Randomized controlled trial

2021 ◽  
Vol 8 (4) ◽  
pp. 574-578
Author(s):  
Ami Bhayani ◽  
Apeksha Patwa
Keyword(s):  
Endotracheal Tube ◽  
Conventional Method ◽  
Direct Laryngoscopy ◽  
Nasotracheal Intubation ◽  
T Test ◽  
Cuff Inflation ◽  
Hemodynamic Parameters ◽  
Magill Forceps ◽  
Intergroup Comparison ◽  
Time Required

The aim of the study is to compare the effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation NTI under direct laryngoscopy.After taking permission from institutional ethical committee, patients of 18-60 years of either sex of ASA grade I and ll were divided into groups of 40 each. In group C, cuff inflation technique and in group M, Magill forceps technique was used for navigating the endotracheal tube from oropharynx to glottic opening to achieve intubation. Parameters observed were time required for intubation, attempts of intubation, injury occurring to oropharyngeal structures during intubation and hemodynamic parameters. Cuff of endotracheal tube was assessed postoperatively for any leaksAnalysis of the data for the various parameters was done using paired t-test for intra-group comparison and student t-test for intergroup comparison and chi-square test was used for qualitative (non parametric) data.There was no significant difference in demographic parameters, time required for intubation, number of attempts for intubation and hemodynamic parameters, but trauma to oropharyngeal structures was more in group M (8/40) compared to group C (0/40). (p≤0.05) Trauma to cuff of endotracheal tube was seen in group M (1/40) while none in group C (0/40) which was statistically not significant (p≤0.05).Thus, Cuff inflation technique can be used as an effective alternative to Magill forceps for oropharyngeal navigation of endotracheal tube under direct laryngoscopy guided nasotracheal intubation in patients with normal airways.

scholarly journals Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation

2020 ◽  
Vol 67 (4) ◽  
pp. 193-199
Author(s):  
Brett J. King ◽  
Ira Padnos ◽  
Kenneth Mancuso ◽  
Brian J. Christensen
Keyword(s):  
Direct Laryngoscopy ◽  
Primary Outcome ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Controlled Clinical Trial ◽  
Oral And Maxillofacial Surgery ◽  
Magill Forceps ◽  
Parallel Group ◽  
Time Required ◽  
Mean Time

This parallel group randomized controlled clinical trial compared intubation duration and success using video laryngoscopy (VL) versus direct laryngoscopy (DL) during routine nasotracheal intubation. Fifty patients undergoing oral and maxillofacial surgery under general anesthesia were randomly assigned into 2 groups receiving either VL or DL to facilitate nasotracheal intubation. The primary outcome was the amount of time required to complete nasotracheal intubation. The secondary outcomes included the success of first attempt at intubation and the use of Magill forceps. Results demonstrated a mean time to intubation of 142 seconds in the DL group and 94 seconds in the VL group (p = .011). First attempt intubation success was 92.0% in the VL group and 84.0% in the DL group (p = .34). The use of Magill forceps was significantly increased in the DL group (p = .007). VL for routine nasotracheal intubation in oral and maxillofacial surgery procedures results in significantly faster intubation times and decreased use of Magill forceps compared with traditional DL.

scholarly journals Nasotracheal Intubation Using the Airtraq Versus Macintosh Laryngoscope: A Manikin Study

2008 ◽  
Vol 55 (3) ◽  
pp. 78-81 ◽  
Author(s):  
Yoshihiro Hirabayashi ◽  
Norimasa Seo
Keyword(s):  
Direct Laryngoscopy ◽  
Macintosh Laryngoscope ◽  
Nasotracheal Intubation ◽  
Line Of Sight ◽  
Intubation Time ◽  
Analog Scale ◽  
Magill Forceps ◽  
The Mean ◽  
Time Required ◽  
Non Line Of Sight

Abstract The Airtraq laryngoscope is a new intubation device that provides a non–line-of-sight view of the glottis. We evaluated this device by comparing the ease of nasotracheal intubation on a manikin with the use of Airtraq versus the Macintosh laryngoscope with and without Magill forceps. Nasotracheal intubation on a manikin was performed by 20 anesthesiologists and 20 residents with the Airtraq or Macintosh laryngoscope. The mean (± SD) time required for nasotracheal intubation by the residents was significantly shorter with the Airtraq laryngoscope than with the Macintosh laryngoscope (16 ± 7 sec vs 22 ± 10 sec; P < .001), but no difference in intubation time was observed between Airtraq (15 ± 11 sec) and Macintosh (13 ± 6 sec) laryngoscopy by the anesthesiologists. The Magill forceps was used more frequently to facilitate intubation with the Macintosh laryngoscope than with the Airtraq laryngoscope in both groups of operators 7(P < .001). The Airtraq laryngoscope scored better on the visual analog scale than did the Macintosh laryngoscope in both groups of operators (P < .05). The Airtraq laryngoscope offers potential advantages over standard direct laryngoscopy for nasotracheal intubation.

scholarly journals Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

2019 ◽  
Author(s):  
ZEHRA İPEK ARSLAN AYDIN ◽  
NEŞE TÜRKYILMAZ
Keyword(s):  
Cricoid Pressure ◽  
Nasotracheal Intubation ◽  
Pressure Head ◽  
Cuff Inflation ◽  
Left Nostril ◽  
Clockwise Rotation ◽  
Vocal Cords ◽  
Magill Forceps ◽  
Head Flexion ◽  
The Right

Background and aim: Nasotracheal Airtraq, is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. Materials and methods: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18-70 years of age undergoing elective maxillofascial, oral and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomised into the right and left nostril groups. Results: Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (p<0.001). 90 anti-clockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (p<0.001 vs p=0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. Conclusion: Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90 anti-clockwise rotation, external laryngeal pressure and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand; cuff inflation maneuver also must be kept in mind. Keywords: Airtraq, nasotracheal, right nostril, 90 degree anticlockwise, cricoid pressure, head flexion

Nasotracheal Intubation

2002 ◽  
Vol 96 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Tom Elwood ◽  
Duane M. Stillions ◽  
Dawn W. Woo ◽  
Heidi M. Bradford ◽  
Chandra Ramamoorthy
Keyword(s):  
Direct Laryngoscopy ◽  
Comparative Studies ◽  
Elective Surgery ◽  
Nasotracheal Intubation ◽  
The Other ◽  
Magill Forceps ◽  
Blinded Observer ◽  
Catheter Technique ◽  
Nasotracheal Tube ◽  
Rubber Catheter

Background Several techniques have been suggested to reduce the trauma of nasotracheal intubation, although no comparative studies exist. The authors evaluated red-rubber catheters as a guide to nasotracheal intubation. Methods Children presenting for elective surgery were randomized to undergo red-rubber catheter-guided nasotracheal intubation or to have the nasotracheal tube alone inserted. After general anesthesia and paralysis with vecuronium, the nares were prepared with topical vasoconstrictor. The nasotracheal tube was softened with warm water. In the catheter-guided group, the nasotracheal tube tip was fitted to the trailing end of the red-rubber catheter, and the two were advanced together. The red-rubber catheter was retrieved from the nasopharynx, disconnected, and removed. In the other group, the nasotracheal tube was advanced blindly into the nasopharynx. In both groups, intubation was then completed during direct laryngoscopy using Magill forceps. A blinded observer swabbed the pharynx and rated the severity of bleeding based on reference photographs. Results Age, weight, snoring history, and difficulty of intubation were not different between groups. Obvious bleeding was lower using the red-rubber catheter technique (10 vs. 29%, P = 0.013), which took longer to perform (74 vs. 56 s, P = 0.02). Conclusions Although the incidence of bleeding in both groups was similar, severity of bleeding was reduced in the catheter-guided group during nasotracheal intubation. Use of a red-rubber catheter may reduce the trauma associated with nasotracheal intubation.

THE EFFECT OF APPLYING SQ3R METHOD ON STUDENTS’ ACHIEVEMENT IN READING COMPREHENSION

2013 ◽  
Vol 2 (2) ◽  
Author(s):  
Pranata Royganda Sihaloho And Masitowarni Siregar
Keyword(s):  
Reading Comprehension ◽  
Research Design ◽  
Conventional Method ◽  
Experimental Research ◽  
T Test ◽  
Control Group ◽  
Multiple Choice Tests ◽  
Choice Tests ◽  
And Control ◽  
Experimental Group

The aim of this study is to discover the effect of applying SQ3R method inreading comprehension. Experimental research design is used as the research method.This research took place at SMA Nasrani 2Medan. There were 2 classes chosen as thesample with 30 students in each class. The classes were divided into two groups namelyexperimental and control group. The experimental group was taught by using SQ3Rmethod and the control group was taught by using conventional method. The instrumentused to collect the data was a set of multiple choice tests, which divided as pre test andpost test. The result of the research was analyzed by using t-test formula. The resultshowed that t-test was higher than t-table (4,23>2,00) at the level of significant 0,05with degree of freedom (df) 58. It means that hypothesis alternative (Ha) is acceptedwhich shows that SQ3R method significantly improves the student’s readingcomprehension.

scholarly journals Mucosal Changes in the Trachea and Main Bronchi of Newborn Infants after Nasotracheal Intubation

1975 ◽  
Vol 3 (3) ◽  
pp. 209-217 ◽  
Author(s):  
G. C. Fisk ◽  
W. de C. Baker
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Squamous Metaplasia ◽  
Nasotracheal Intubation ◽  
Newborn Infants ◽  
Respiratory Epithelium ◽  
Lower Trachea ◽  
Nasotracheal Tube ◽  
Mucosal Changes ◽  
The Right

Permanent sequelae of nasotracheal intubation are uncommon, but acute ulceration and squamous metaplasia occur. Histological sections from the trachea and main bronchi were examined in 12 infants. A nasotracheal tube had been inserted during the first two weeks of life of these infants and had been in place for more than one week. In four cases the patient died some time (7 to 108 days) after extubation. Similar sections from patients who were not intubated, intubated only for attempted resuscitation, or intubated for several hours were studied for comparison. The sections were classified according to the degree of mucosal loss and metaplasia, and the extent of the lesions was estimated. Squamous change was seen in most sections from all 12 patients with the exception of one who died 57 days after extubation. Some respiratory epithelium was seen in all patients. In the eight patients who died while intubated, the changes were more marked in the right main bronchus than the left in seven, and more marked in the lower trachea than the upper in five. In the two patients intubated for several hours, in addition to mucosal loss, early metaplasia was seen. It is suggested that mucosal loss is replaced by the squamous metaplasia, and that trauma caused by suction catheters in the lower trachea and right main bronchus is more extensive than that due to the endotracheal tube itself.

Comparison of a Colorimetric End-Tidal CO2 Detector and an Esophageal Aspiration Device for Verifying Endotracheal Tube Placement in the Prehospital Setting: A Six-Month Experience

1997 ◽  
Vol 12 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Richard J. Schaller ◽  
J. Stephen Huff ◽  
Allan Zahn
Keyword(s):  
Cardiac Arrest ◽  
Endotracheal Tube ◽  
Sensitivity And Specificity ◽  
Nasotracheal Intubation ◽  
Prehospital Setting ◽  
Tube Placement ◽  
Emergency Department Physician ◽  
Significant Difference ◽  
End Tidal ◽  
Chi Square Analysis

AbstractIntroduction:Hand held, colorimetric, end-tidal CO2 detector devices are being used to verify correct endotracheal tube (ETT) placement. The accuracy of these devices has been questioned in situations of cardiac arrest. The use of the esophageal detector device (EDD) is an easy alternative for detection of ETT placement, and may be more accurate in situations of cardiac arrest.Hypothesis:The use of the esophageal aspiration device in comparison with a colorimetric end-tidal CO2 detector is more accurate in detecting proper ETT placement and easier to use in the prehospital setting than is the colorimetric end-tidal CO2 detection device.Methods:This was a prospective alternating weeks, 6-month study in a prehospital setting. Participants included all patients older than 18 years who were intubated by the Portsmouth, Virginia Emergency Medical Services (EMS) personnel from 01 July 1993 through 31 December 1993. The aspiration device used, also known as an esophageal detector device (EDD), was a 60 ml, luer-lock syringe attached to a 15 mm ETT adapter. Its efficacy was compared with an already accepted method of ETT position detection, the colorimetric endtidal CO2 detector. Each device was used on alternating weeks, and correct ETT placement was determined by the receiving emergency department physician using standard techniques. Chi-square analysis and Fisher's Exact test were used to compare parameters, time of device use, and ease of use. Sensitivity and specificity were calculated, and provider preference was assessed using a survey instrument administered following completion of the study.Results:There were 49 patients who met the inclusion criteria, but six were excluded because of situational circumstances rendering use of the device a possible compromise of patient care. Twenty-five patients were in the EDD group, and 18 were in the endtidal CO2 detector group. There was no statistically significant difference detected between groups for the gender ratio, underlying condition, CPR in progress, perceived difficulty of intubation, or percentage of nasotracheal intubation. The EDD was significantly easier to use (p<0.005). There was no statistically significant difference in time required for use of end-tidal CO2 detector device versus the EDD. The sensitivity and specificity for correct tracheal placement using the EDD was 100%, and the sensitivity for correct tracheal placement using the end-tidal CO2 detector device was 78%. Use of the EDD was preferred over use of the end-tidal CO2 detector device by 75% of participating EMS providers. One case of nasotracheal intubation with an ETT placement above the cords raised the question of accuracy of this device in situations where direct visualization is not utilized.Conclusion:The EDD was accurate in all cases of orotracheal intubation, and was easier to use than was end-tidal CO2 detector device. It was preferred by 75% of participating EMS providers. In cases in which the ETT may be above the vocal cords, caution must be used with interpreting the results obtained by use of the EDD.

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