Softening tube with warm saline can reduce epistaxis during nasotracheal intubation

Abstract

Softening tube with warm saline can reduce epistaxis during nasotracheal intubation

Yong Chul Kim, Sang Yoon Cho, Jong Hoon Yeom, Woo Jong Shin, and Dong Ho Lee

Introduction: Previously we had reported that the softening tube with warm saline during nasotracheal intubation can reduce the epistaxis.1) In this study, we determined which temperature of warm saline can most effectively reduce it. Methods: One hundred and fifty patients, ASA PS 1-3, aged over 16 yr, undergone general anesthesia, were included. Preoperatively, nasal symptoms and deformities wee evaluated. The patients were randomly allocated to three groups: control group (25℃ of room temperature; n=50), 35℃ treated group (n=50), and 45℃ treated group (n=50). About 30 min before intubation, the tubes (nasal RAE, Mallinckrodt, Ireland) were prepared at room temperature (25℃) or into a heating cabinet (35℃ and 45℃) according to the previous method.1) Epistaxis was evaluated during both intubation and extubation on a scale of 0 to 3.2) At PACU, otolaryngologist blindly assessed the site and nature of nasal damage following nasotracheal intubation using an otoscope. Immediately before transfer to the ward, nurses checked about difficult breathing. nasal bleeding and pain. Results : The warm saline treated groups showed lower incidence of epistaxis during intubation and nasal damage than control group (p<0.05). However, there were no differences on epistaxis during extubation, postoperative subjective nasal symptoms, and tube deformities. Conclusion: Our data indicated that warm saline treated tube technique above 35℃ can effectively reduce epistaxis and ensure smooth navigability through nasopharynx during intubation. References: 1. Kim YC et al.: The 42th KSA Autumn Meeting Abstracts. 1997, pp67. 2. Katz et al. : J Clin Anesth 1990; 2:16-20