The influence of endotracheal tube tip design on nasal trauma during nasotracheal intubation: magill-tip versus murphy-tip

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Lee, Jong-Hwan; Kim, Chang-Hee; Bahk, Jae-Hyon; Park, Kum-Suk
Issue Date
Anesth Analg. 2005 Oct;101(4):1226-9, table of contents.
Adult*Equipment DesignFemaleHumansIntubation, Intratracheal/adverse effects/*instrumentationMaleMiddle AgedNasal Cavity/*injuries
We performed this study to assess the influence of endotracheal tube (ETT) tip design (Murphy-tip versus Magill-tip) on nasal trauma during nasotracheal intubation with a conventional polyvinyl chloride ETT. Patients were randomly allocated to one of four groups (n = 25 each): Magill-tipped ETT and Murphy-tipped ETT with or without thermosoftening. After preparation with a vasoconstrictor, the selected, well-lubricated ETT was advanced blindly into the nasopharynx, and intubation was completed under direct laryngoscopy. The severity of epistaxis was estimated based on the distance that blood had traveled up the suction catheter and tubing. Without thermosoftening, the Murphy-tipped ETT produced more severe epistaxis than the Magill-tipped ETT (P < 0.05). Thermosoftening effectively reduced the severity of epistaxis for both conventional types of ETT (P < 0.05). However, there was no difference in the severity of epistaxis and the incidence of nasal injury and pain between the Magill-tipped, non-thermosoftened ETT and Murphy-tipped, thermosoftened ETT. Thermosoftening is recommended because it decreases the trauma during nasotracheal intubation. However, if one chooses to use a normal ETT, the Magill-tipped ETT will cause fewer traumas than the Murphy-tipped ETT. IMPLICATIONS: During nasotracheal intubation with conventional endotracheal tubes, Magill-tipped, non-thermosoftened tubes seem to be comparable to Murphy-tipped, thermosoftened tubes with regard to trauma on the nasal mucosa.
0003-2999 (Print)
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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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