Does a Nasal Airway Facilitate Nasotracheal Intubation or Not? A Prospective, Randomized, and Controlled Study

Canpolat, Dilek Günay; Yaşlı, Seher Orbay

doi:10.1016/j.joms.2020.08.029

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…Several pretreatment methods for nasal intubation using vasoconstrictors [ 19 ], nasal airway tube [ 20 ], or cotton swab [ 10 ] have been reported. Generally, cotton swab is used after the use of vasoconstrictors or nasal airway tube to check the passage of NTI.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, cotton swab is used after the use of vasoconstrictors or nasal airway tube to check the passage of NTI. As for the nasal airway tube, it is reported that inserting a nasal airway into the nostril just before the NTI may facilitate the intubation process by preparing the nasal passage [ 20 ]. However, in this study, we did not use nasal airway or cotton swab in order to examine the effects of vasoconstrictors alone.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that persistent bleeding can also affect the operative field, every effort should be made to prevent bleeding whenever possible. Several pretreatment methods for nasal intubation using vasoconstrictors [19], nasal airway tube [20], or cotton swab [10] have been reported. Generally, cotton swab is used after the use of vasoconstrictors or nasal airway tube to check the passage of NTI.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of hemostatic effect and safety between epinephrine and tramazoline during nasotracheal intubation: a double-blind randomized trial

et al. 2021

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Background Nasal bleeding is the most common complication during nasotracheal intubation (NTI). To reduce nasal bleeding, the nasal mucosa is treated with vasoconstrictors (epinephrine [E] or tramazoline [T]) prior to NTI. This study aimed to determine whether E or T is more effective and safe for reducing nasal bleeding during NTI. Methods This study was preregistered on UMIN-CTR after being approved by the IRB of the School of Dentistry at Aichi Gakuin University. Written consent was received from all the patients. Total 206 patients aged 20–70 years and classified as 1–2 on American Society of Anesthesiologists-physical status were scheduled to undergo general anesthesia with NTI. At last, 197 patients were randomly divided into two groups and treated with either E (n = 99; 3 patients were discontinued) or T (n = 98; 2 patient were discontinued). After induction of general anesthesia, each patient’s nasal mucosa was treated using either E or T. The E used in this study was BOSMIN® SOLUTION 0.1% (Daiichi-Sankyo Co., Ltd., Tokyo), and the T used in this study was TRAMAZOLIN Nasal Solution 0.118% AFP, (Alfresa Pharma Corporation, Osaka). E was diluted five times according to the package insert (final concentration of E = 0.02%), and T was used in its original solution. After 2 min, NTI was performed via the right nostril. Primary outcome were the presence of nasal bleeding (if bleeding was recognized at the posterior pharyngeal wall via nasal cavity during intubation, it was defined as bleeding) and the degree of bleeding (classified as none, mild, moderate, or severe). Secondary outcomes were arrhythmia, and hemodynamic (mean atrial pressure and heart rate) changes associated with vasoconstrictors. Results The presence of bleeding was comparable in both groups (12.5%, E; 14.5%, T; P = 0.63). No significant difference between the groups regarding the degree of bleeding (P = 0.78) was observed, with most patients having no bleeding (n = 84, E; n = 82, T). No severe bleeding and no arrhythmias induced by vasoconstrictor were observed in the two groups. Conclusions Nasal treatment with E or T shows no difference in nasal bleeding during NTI. Although no arrhythmia associated with E was observed in this study, it has been reported in literature. Therefore, as frequency and degree of nasal bleeding were comparable, nasal treatment with T could reduce the risk of NTI. Trial registration UMIN-CTR (Registration No. UMIN000037907). Registered (05/09/2019).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of hemostatic effect and safety between epinephrine and tramazoline during nasotracheal intubation: a double-blind randomized trial

et al. 2021

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Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 2

Statman¹

2023

Anesthesia Progress

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Part 1 of “Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery” covered the physiological process of hemostasis and the pharmacology of both traditional and novel oral antiplatelets and anticoagulants. Part 2 of this review discusses various factors that are considered when developing a perioperative management plan for patients on oral antithrombotic therapy in consultation with dental professionals and managing physicians. Additionally included are how thrombotic and thromboembolic risks are assessed as well as how patient- and procedure-specific bleeding risks are evaluated. Special attention is given to the bleeding risks associated with procedures encountered when providing sedation and general anesthesia within the office-based dental environment.

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Does a Nasal Airway Facilitate Nasotracheal Intubation or Not? A Prospective, Randomized, and Controlled Study

Cited by 2 publications

References 21 publications

Comparison of hemostatic effect and safety between epinephrine and tramazoline during nasotracheal intubation: a double-blind randomized trial

Comparison of hemostatic effect and safety between epinephrine and tramazoline during nasotracheal intubation: a double-blind randomized trial

Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 2

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