CONVENTIONAL NASOTRACHEAL INTUBATION VERSUS RED RUBBER CATHETER-GUIDED NASOTRACHEAL INTUBATION- RANDOMIZED STUDY

Abstract

Introduction: Various techniques have been formulated and suggested to reduce the trauma of nasotracheal intubation. Hence the evaluation is done between Conventional Nasotracheal intubation versus red rubber catheter-guided nasotracheal intubation.

Methods:

Paediatric age group presenting for elective surgery were randomized to undergo red rubber catheter-guided nasotracheal intubation or to have the nasotracheal tube alone inserted after administering of general anaesthesia and paralysis of patient with vecuronium. The nares were prepared with topical vasoconstrictor. The nasotracheal tube was softened with lubricant jelly. In the catheter guided group, the nasotracheal tube tip was fitted to the trailing end of the red rubber catheter, and the two were advanced together. The red-rubber catheter and the two were advanced together. The red rubber catheter was retrieved from the nasopharynx, disconnected, and removed. In the other group, the nasotracheal tube was advanced blindly into the nasopharynx. In both the groups, intubation was successfully completed during direct laryngoscopy using Magill forceps. A observer who is blinded will swab the pharynx and rated the severity of bleeding.

Results: Age, weight, difficulty of intubation, and snoring history, are same in two groups. Anticipated bleeding was lower using the red rubber catheter technique (10vs.29%,P=0.013), which took longer time interval to perform(74vs.56 s,P=0.02)

Conclusions: Although the incidence of bleeding in both groups was similar, severity of bleeding was reduced in the catheter guided group during nasotracheal intubation. Use of a red rubber catheter may reduce the trauma associated with nasotracheal intubation.