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Effect of neck extension on the advancement of tracheal tubes from the nasal cavity to the oropharynx in nasotracheal intubation: a randomized controlled trial

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Authors
Kim, Hyerim; Lee, Jung-Man; Lee, Jiwon; Hwang, Jin-Young; Chang, Jee-Eun; No, Hyun-Joung; Won, Dongwook; Row, Hyung Sang; Min, Seong-Won
Issue Date
2019-08-17
Publisher
BioMed Central
Citation
BMC Anesthesiology, 19(1):158
Keywords
IntubationNasotrachealNeck extensionTracheal tube
Abstract
Background
Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril, from the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to investigate the effect of neck extension on the advancement of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation.

Methods
Patients were randomized to the ‘neck extension group (E group)’ or ‘neutral position group (N group)’ for this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the E group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patient’s neck extended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was successfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned group, the case was defined as ‘success.’ We compared the success rate of tube advancement between the two groups.

Results
Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube passage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%; odds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002).


Trial registration: ClinicalTrials.gov Identifier NCT03377114, registered on 13 December 2017.
ISSN
1471-2253
Language
English
URI
http://hdl.handle.net/10371/162605
DOI
https://doi.org/10.1186/s12871-019-0831-6
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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