The Effect of 'Sniffing Position & Nasal Tip Lifting' in Nasotracheal Intubation

Intubation Complication Clinical Trial

Official title:

The Effect of 'Sniffing Position & Nasal Tip Lifting' on the Pathway of Tracheal Tube in Nasal Cavity During Nasotracheal Intubation

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03102255
• Other study ID #: 20160707/26-2016-90/072
• Status: Completed
• Phase: N/A
• First received: March 20, 2017
• Last updated: October 12, 2017
• Start date: August 1, 2016
• Est. completion date: July 21, 2017

Study information

• Verified date: October 2017
• Source: Seoul National University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this prospective randomized study is to compare the effect of nasal tip lifting during nasotracheal intubation.

The question the investigators are trying to answer is: If the nasal tip is tilted, will the E-tube be more likely to enter the lower passage during nasal intubation?

Description:

There are three nasal turbinates inside the nasal cavities. Each nasal cavity is divided into four spaces from these nasal turbinates, but the two spaces separated by the upper nasal turbinate are too narrow to be clinically meaningful. So when performing nasotracheal intubation, the tube enters one of the two spaces in low part divided into the lower turbinate. The middle turbinate, unlike others, a large number of blood vessels and nerves are distributed. Therefore, less hemorrhage might occurs when the tracheal tube enters into the lower pathway below the lower turbinate because the tube would not scratching the middle turbinate.

The hypothesis of this study is that the method 'sniffing position and nasal tip lifting' increases possibility to enter into lower pathway when the tube enters the nasal cavity. The purpose of a present study was to investigate the effect of 'sniffing position & nose' on the intranasal route of the tube.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 86
• Est. completion date: July 21, 2017
• Est. primary completion date: June 5, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• The patients who need to nasotracheal intubation for surgery.

Exclusion Criteria:

• Who doesn't agree to enroll.

• Who has severe nasal deformities.

• Who has a problem to make sniffing position or nasal tip lifting

• Who has severe nasal bleeding history.

Related Conditions & MeSH terms

• Intubation Complication

Intervention

Procedure:
• Sniffing position
All procedure is done under sniffing position.
• Nasal tip lifting
Before inserting the endotracheal tube to patient's nose, the researcher lift up the nose tip.

Locations

Country	Name	City	State
Korea, Republic of	Seoul National University Boramae Hospital	Seoul

Sponsors (1)

Lead Sponsor	Collaborator
Seoul National University Hospital

Country where clinical trial is conducted

Korea, Republic of, 

References & Publications (5)

Ahmed-Nusrath A, Tong JL, Smith JE. Pathways through the nose for nasal intubation: a comparison of three endotracheal tubes. Br J Anaesth. 2008 Feb;100(2):269-74. Epub 2007 Dec 14. — View Citation

Dost P, Armbruster W. Nasal turbinate dislocation caused by nasotracheal intubation. Acta Anaesthesiol Scand. 1997 Jun;41(6):795-6. — View Citation

Patiar S, Ho EC, Herdman RC. Partial middle turbinectomy by nasotracheal intubation. Ear Nose Throat J. 2006 Jun;85(6):380, 382-3. — View Citation

Scamman FL, Babin RW. An unusual complication of nasotracheal intubation. Anesthesiology. 1983 Oct;59(4):352-3. — View Citation

Williams AR, Burt N, Warren T. Accidental middle turbinectomy: a complication of nasal intubation. Anesthesiology. 1999 Jun;90(6):1782-4. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of patients with nasal endotraheal tube in the lowest nasal pathway.	After the endotracheal intubation is completed, the experimenter confirms by a fiberoptic bronchoscope which path the endotracheal tube is located.	Through study completion, an average of 1 year
Secondary	Nasal bleeding	After nasotracheal intubation, the researcher confirm there is nasal bleeding or not. And if bleeding observed, the experimenter would check the amount.	Through study completion, an average of 1 year
Secondary	Intubation time	Check the time from initiation of insertion of E-tube to finish passing nasal path and to finish intubation.	Through study completion, an average of 1 year