Suction Catheter as a Guide for Nasotracheal Intubation Under General Anesthesia

Suction Catheter as a Guide for Nasotracheal Intubation Under General Anesthesia: Randomized Clinical Trial of Efficacy

The goal of this clinical trial to study the efficacy of suction catheter guided technique and conventional technique during nasotracheal intubation.

The main question are

• How effective of the use of a suction catheter guided ETT in reducing bleeding during nasotracheal intubation?
• Does the use of a suction catheter guided ETT can improve its navigability through the nasal passage and reduce nasal passage time?

Study design Clinical trial: Prospective randomized controlled trial with equal randomization (1:1), double-blinded (Participant and Primary outcome assessor), parallel design

Inclusion Criteria:

• Patient undergoing elective oral and maxillofacial surgery in which nasotracheal intubation is preferred over orotracheal intubation to optimize surgical access.
• ASA physical status I-II
• Thai adult, aged 18-65 years old
• Normal Body Mass Index (BMI = 18.5-24.9)

Exclusion Criteria:

• Anticipated difficult airway (e.g., Mallampati classification 3-4, interincisal distance < 35 mm., thyromental length < 60 mm., limited neck mobility)
• Nasal infection or systemic infection
• Abnormal coagulation status or having bleeding disorder or taking anticoagulation/antiplatelet medication
• History of recurrent epistaxis since adulthood
• Allergic rhinitis that necessitates the use of glucocorticoids, antihistamine, antileukotriene or decongestant in the past 4 weeks
• History of nasal trauma or abnormality (e.g., trauma in mid-face region, nasal surgery, nasal polyps, chronic sinusitis, abnormal nasal vasculature, tumor in nasal region, radiotherapy in nasal region)
• Craniofacial deformity syndrome
• Using nasal oxygen or Continuous Positive Airway Pressure (CPAP)
• Previous nasotracheal intubation or nasogastric tube placement within 3 months
• Diagnosed as having a mental disorder

Drop-out criteria:

• Unable to complete intubation procedure
• Intubation failed on both nostrils
• When intubation was only possible with a tube smaller than 6.5 internal diameter (ID) in male and 6.0 ID in female
• Inadequate data collection