scholarly journals Resurgence of blind nasal intubation with videolaryngoscopy as a guide for head maneuvers in the course of nasotracheal intubation in panfacial fracture patients with severely restricted mouth opening

Author(s):  
Kaushal Kumar
2011 ◽  
Vol 58 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Allen Wong ◽  
Paul Subar ◽  
Heidi Witherell ◽  
Konstantin J Ovodov

Nasal intubation is an advantageous approach for dental procedures performed in the hospital, ambulatory surgery center, or dental office, when possible. Although many who provide anesthesia services are familiar and comfortable with nasal intubation techniques, some are reluctant and uncomfortable because of lack of experience or fear of nasopharyngeal bleeding and trauma. It has been observed from experiences in various settings that many approaches may be adapted to the technique of achieving nasal intubation. The technique that is described in this paper suggests a minimally invasive approach that introduces the nasoendotracheal tube through the nasopharyngeal pathway to the oropharynx in an expedient manner while preserving the nasopharyngeal structures, thus lessening nasal bleeding and trauma to soft tissues. The technique uses a common urethral catheter and can be incorporated along with current intubation armamentaria. As with all techniques, some limitations to the approach have been identified and are described in this paper. Cases with limited mouth opening, neck injury, and difficult airways may necessitate alternative methods. However, the short learning curve along with the many benefits of this technique offers the anesthesia professional additional options for excellent patient care.


2018 ◽  
Vol 65 (4) ◽  
pp. 259-260 ◽  
Author(s):  
Tsuyoshi Hoshi ◽  
Takashi Suzuki ◽  
Masayuki Somei ◽  
Takehiko Iijima ◽  
Yuka Kurihara

A 23-year-old healthy man was scheduled for extraction of his mandibular third molars under general anesthesia with nasotracheal intubation. Sudden sinus tachycardia up to 170 beats/min occurred when applying an epinephrine solution-soaked swab into the nasal cavity for preventing epistaxis during intubation. This was presumably evoked by submucosal migration of the swab into a false passage created because of the force applied during a prior failed attempt at nasal passage of the tracheal tube, and rapid epinephrine absorption by the traumatized mucosa. The causes of the unexpected severe tachycardia in our patient are discussed.


2011 ◽  
Vol 28 ◽  
pp. 237 ◽  
Author(s):  
R. Sanchez ◽  
Simon C. Añez ◽  
Parraga C. Ivars ◽  
Marques L. Santos ◽  
Gonzalvo V. Serrano ◽  
...  

2016 ◽  
Vol 30 (5) ◽  
pp. 904-906 ◽  
Author(s):  
Zehra İpek Arslan ◽  
P. Ozdal ◽  
D. Ozdamar ◽  
H. Agır ◽  
M. Solak

2021 ◽  
Vol 68 (2) ◽  
pp. 107-113
Author(s):  
Vernon H. Vivian ◽  
Dip Anaes ◽  
Tyson L. Pardon ◽  
Andre A. J. Van Zundert

Nasotracheal intubation remains an underused but invaluable technique for securely managing the airway during oral and maxillofacial surgery. In this article, we present a modified clinical technique that allows for the potential introduction into clinical practice of 2 new airway devices: a nasal laryngeal mask airway and an interchangeable oral/nasal endotracheal tube. We hypothesize that with the use of proper techniques, these devices can add new and safer alternatives for securing an airway by the nasal route. The advantage of this novel technique is that the airway is secured by the oral route prior to performing a modified retrograde nasal intubation, eliminating the danger of profuse epistaxis precipitating a “cannot intubate, cannot ventilate” scenario. In addition, the design and materials used in the components of the devices may minimize trauma. The authors aim to inform clinicians about the indications, physical characteristics, and insertion/removal techniques related to these new devices.


2016 ◽  
Vol 9 (4) ◽  
Author(s):  
Khalid Javed ◽  
Ambrin Amjad ◽  
Muhammad Abdul Aziz

Temporomandibular joint ankylosis presents a serious problem for airway management. Alternate or additional technique of airway control are required in this condition. Different options include blind nasotracheal intubation, fiberoptic intubation, retrograde intubation or tracheostomy. Moreover, the patient could be awake or asleep. The purpose of our study was to describe our experience with blind nasotracheal intubation after induction of general anesthesia with spontaneous ventilation in patients of temporomandibular ankylosis presenting for corrective surgery. This experience was gained on all the patients of temporomandibular joint ankylosis presenting to fasciomaxillary department at Mayo Hospital, Lahore over a period of 1 1/2 years. The surgery done was gap arthroplasty with genioplasty. Thirty six patients (male:24, female: 12) with age ranging between 3 years to 25 years with a mean of 12.56 years were studied. All the patients received premedication with atropine 10mg/kg body weight to dry up secretion. Patients were deeply anaesthetized with Halothane, Nitrous oxide with 50% oxygen. Thirty four patients were successfully intubated. Blind nasal intubation failed in 2 patients. The successful blind nasotracheal intubation for surgery for TMJ ankylosis needs adequately and deeply anaesthetized patients, relatively small well lubricated endotracheal tube passed through patent naris with atropine as premedication.


2006 ◽  
Vol 13 (04) ◽  
pp. 669-675
Author(s):  
ZAHID MEHMOOD CHEEMA ◽  
MANZAR ZAKARIA ◽  
NOMAN ALI MALIK

Objective: Blind Nasotracheal Intubation (BNI) can be undertaken aftermuscle relaxation with Inj. Succinylcholine or under deep inhalational anesthesia. The objective of study was todetermine the preferred one of these 2 techniques of BNI. Design: Prospective, randomized study. Place andDuration of Study: PNS SHIFA, Karachi and AFID, Rawalpindi from May 2002 to April 2005. Subjects and Methods:Sixty patients between 10 - 40 years of age presenting for elective surgery in whom BNI was required due to limitedor no mouth opening were enrolled through convenient sampling. Patients were randomly divided into two groups:WMR (n=30) or NMR (n=30) to undergo BNI after relaxation with Succinylcholine or under inhalational anesthesia with2% Halothane, respectively. A red rubber nasal endotracheal tube (cuffed and un cuffed in adults and childrenrespectively) was used. Results: The frequency of successful BNI in WMR group was 100% and significantly higher(P=0.03) than in the NMR group (86%). Time to succeed was significantly less in the WMR group 2±0.9 minutes versus3.4±2.0 in the NMR group. There was no statistically significant difference of occurrence of adverse events in the twogroups. Conclusion: BNI with Succinylcholine produced a higher success rate. This technique can decrease failureto intubate, we speculate that it may, therefore, increase patient safety.


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