Evaluating Novel Technique of Blind Nasotracheal Intubation Using Ivory White Tube In Patients With Multiple Facial Fractures For Repair Using Thyroid Bulge As Landmark
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Introduction: As an anesthetist securing airway is the key in management of severe fractures of face and for this different techniques have been described. Blind nasal intubation is one of the technique for securing airway. Aim: We share our experience of performing novel technique of blind nasotracheal intubation in airway management of 30 facial fracture patients planned for facial fracture repair. We evaluated a new thyroid bulge as landmark for guiding blind nasal intubation, its success rate and complications. Material and Method: After taking patient consent total 30 patients posted for facial fracture repair requiring GA were enrolled for the study. Their age ranged from 16 to 50 yrs, weight ranged from 40 to 60 kg and they were belonging to ASA I and II. Conventional general anesthesia was administered in all cases. A well lubricated proper size Ivory tube was inserted through more patent nostril after decongesting it till tube reached oropharynx and was pushed to see bulge on one side of thyroid cartilage. After assessing distance between thyroid bulge due distal end of tube and chin, tube was withdrawn in oropharynx and rotated in opposite direction, directing it towards midline advancing in, till it entered glottis. Tube placement was confirmed by capnograph, auscultation & bilateral symmetrical chest expansion. Results: We successfully intubated 60% patients in 1st attempt, 30% of patients in 2nd attempts, and 6% in 3 attempts and only one patient required Magill’s forceps guided intubation. None of our patient had any major complications. Bleeding was noted in 3 cases only. Hemodynamics and SpO2 remained normal throughout procedure. The postoperative period was uneventful. Conclusion: We successfully used this novel technique for blind nasotracheal intubation in elective facial fracture repairs. So this age old method of blind nasotracheal intubation is still very easy and successful in securing airway.
Authors and Affiliations
Dr. Sunil Chapane, Dr. R D Patel, Dr. Aarti Kulkarni, Dr. Minoti Potdar
Keywords
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- EP ID EP243724
- DOI 10.9790/0853-1610068893
- Views 77
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