Nasotracheal Intubation Over a Bougie

University of Iowa257 enrolled

Overview

The purpose of this study is to determine whether nasal intubation over a bougie placed via a nasal trumpet will decrease nasal trauma when compared to the conventional technique of blind nasal endotracheal tube passage.

Conventional nasotracheal intubation techniques (or "Conventional Videolaryngoscopic Techniques," CVT) are known to be associated with significant trauma to the patient's nares and the endotracheal tube itself. The investigators propose an alternative technique (Nasotracheal intubation over a bougie placed via a subsequently removed nasal trumpet, or NIB) which involves using Seldinger technique over a bougie placed via a nasal trumpet which promises to not only be less traumatic to the patient and the endotracheal tube, but also to take less time to perform and have a higher first-attempt success rate than conventional methods. The investigators propose a randomized prospective interventional study comparing this new technique with conventional technique to see if a significant difference exists.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

257

Conditions

Nasotracheal Intubation Nasal Bleeding

Interventions

Nasotracheal intubation over a bougiePROCEDURE

Nasotracheal intubation over a bougie, placed with videolaryngoscopy assistance, via a nasopharyngeal airway with or without the aid of Magill forceps

Conventional Nasotracheal IntubationPROCEDURE

Blind passage of an endotracheal tube via the nare followed by videolaryngoscopy-assisted passage through the glottis, with or without the aid of Magill forceps

Eligibility

Sex: ALLMin age: 8 YearsMax age: 99 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients scheduled for elective surgery with an anesthetic plan including asleep nasotracheal intubation Exclusion Criteria: * Patients needing emergent airway protection * Patients undergoing emergency surgery * Patients whom are known to be pregnant * Patients whom are currently anticoagulated (including daily aspirin use) * Patients whose anesthetic includes the use of nitrous oxide * Patients whom are currently incarcerated * Patients 7 years of age or younger * Mentally incompetent adults * Patients whom refuse involvement in the study

Locations (1)

The University of Iowa Hospitals and Clinics

Iowa City, Iowa, United States

Outcomes

Primary Outcomes

Nasal trauma

Bleeding noted on nasopharyngeal exam by surgical resident

Time frame: 60-90 seconds post-intubation

Secondary Outcomes

Nasal trauma

Bleeding noted on nasopharyngeal exam by surgical resident

Time frame: 5 minutes post-intubation

Time to intubation

Time from first entrance of ETT or bougie into the nare to the presence of end-tidal CO2 via nasotracheal ETT

Time frame: Measured immediately post-intubation

First attempt success rate

Whether or not there was successful nasotracheal intubation on the first attempt

Time frame: Measured immediately post-intubation

Need for Magill forceps

Whether or not Magill forceps were used during airway management

Time frame: Measured Immediately post-intubation

Data from ClinicalTrials.gov

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