Nasal Intubation Clinical Trial
Official title:
Tracheal Tube Cuff Inflation-deflation Method for Video Laryngoscope-assisted Nasal Intubation in Pediatric Patients
Magill forceps is used to maneuver the endotracheal tube ETT in the posterior oropharynx and
place its tip into the laryngeal inlet. While the Magill forceps are useful in guiding the
nasotracheal tube past the vocal cords, care must be taken to avoid excessive maneuvering in
order to minimize the risk of local trauma and rupture of the nasotracheal tube balloon.
Cuff inflation-deflation method can reduce the apnea time in the pediatric patients, a
population with known physiological limitations in respiratory reserve. This, in turn, could
point to a reduction in the complications (as desaturation and cardiac arrhythmia) that
associated with the prolonged-time procedure.
the investigator will compare the cuff inflation-deflation method versus the conventional
method of nasal intubation in pediatric patients for the need of using Magill forceps 90
pediatric patients between the ages of 3 and 12 years with the American Society of
Anesthesiologists (ASA) physical status I-II, scheduled for elective surgery (dental and
maxillofacial) will be enrolled in a prospectively randomized observer-blinded clinical
trial. Patients, who have coagulopathies, have upper airway abnormalities, at risk for
aspiration or by reasons of parent's refusal will be excluded from the study.
Airway management is subdivided into phases:
- Phase 1: Passage of the endotracheal tube through the nose into the pharynx
- Phase 2: Video-laryngoscope-guided passage of the endotracheal tube through the pharynx
into the trachea.
Phase 2 can be performed with the tracheal tube cuff inflation-deflation method vs. non-cuff
inflation method. A Magill forceps can be used to guide the endotracheal tube pass through
the pharynx and glottis into the trachea if required.
Tracheal tube cuff inflation-deflation method: Tracheal tube cuff is inflated with a variable
amount of air (volume of air is depending on the level of the larynx). Once the tip of
endotracheal tube at the laryngeal inlet, the cuff of the endotracheal tube is deflated and
advanced into the trachea
Patients included in the study will be assigned into two groups for the second phase of
airway management:
Group A (n = 45) in whom nasal intubation will be performed using the cuff
inflation-deflation method; and Group B (n = 45), in whom the nasal intubation will be
performed using non-inflation method.
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