Risk Factors for Epistaxis during Nasotracheal Intubation

Abstract

Background: We performed this study to confirm which risk factors are significantly associated with epistaxis during nasotracheal intubation and to discuss the possible strategies to avoid it.

Methods: One hundred patients who underwent nasotracheal intubation were included. Risk factors for epistaxis were analyzed using both logistic regression analysis and correspondence analysis.

Results: Epistaxis more likely to occur when repeated intubations were attempted (P = 0.0001, odds ratio = 3.53) and if transit of tube through nasal passageways was difficult (P = 0.0001, odds ratio = 6.25). On the other hand, age and gender, obesity, smoking, tube size, nostril selected, and intubation performed with the aid of a Magill forceps did not closely relate with epistaxis. Preoperative otolaryngological evaluation of nasal anatomical abnormalities also did not show close relation with epistaxis.

Conclusions: Strategies to ensure smooth transit of tube through nasal passageways and avoid repeated attempts of intubation would be essential to reduce the incidence of epistaxis.