Intubación nasal / Nasal intubation

Noviembre 28, 2016. No. 2522

Intubación nasal. Una revisión completa Nasal intubation: A comprehensive review Chauhan V, Acharya G. Indian J Crit Care Med 2016;20:662-7 Abstract Nasal intubation technique was first described in 1902 by Kuhn. The others pioneering the nasal intubation techniques were Macewen, Rosenberg, Meltzer and Auer, and Elsberg. It is the most common method used for giving anesthesia in oral surgeries as it provides a good field for surgeons to operate. The anatomy behind nasal intubation is necessary to know as it gives an idea about the pathway of the endotracheal tube and complications encountered during nasotracheal intubation. Various techniques can be used to intubate the patient by nasal route and all of them have their own associated complications which are discussed in this article. Various complications may arise while doing nasotracheal intubation but a thorough knowledge of the anatomy and physics behind the procedure can help reduce such complications and manage appropriately. It is important for an anesthesiologist to be well versed with the basics of nasotracheal intubation and advances in the techniques. A thorough knowledge of the anatomy and the advent of newer devices have abolished the negative effect of blindness of the procedure. PDF Intubación nasal con fibroscopio con paciente sentado en cirugía electiva de mandíbula bajo anestesia general Sitting Nasal Intubation With Fiberoptic in an Elective Mandible Surgery Under General Anesthesia. Etemadi SH1, Bahrami A2, Farahmand AM2, Zamani MM3. Anesth Pain Med. 2015 Nov 28;5(6):e29299. doi: 10.5812/aapm.29299. eCollection 2015. Abstract INTRODUCTION: Patients with mandible deformity may die, as a result of airway management failures. The awake nasal fiberoptic intubation is known as the optimum intubation method, in the mentioned patients, although, in several cases, fiberoptic intubation fails. CASE PRESENTATION: The present case discusses a patient with severe deformity of mandible that was admitted for correction with free-flap. The following intubation techniques were used for her airway management, respectively: blind awake nasal intubation, awake oral fiberoptic and awake nasal fiberoptic, which failed all. We therefore decided to perform awake nasal intubation, with fiberoptic, in sitting position. CONCLUSIONS: In this case, after failure of awake fiberoptic intubation, awake direct laryngoscopy and blind nasal intubation, finally awake nasal intubation in sitting position, using fiberoptic led to success. KEYWORDS: Airway Management; Endotracheal Intubation; Fiber Optic Technology; Free Flaps; Intubation PDF Uso de sonda nasogástrica para facilitar intubación nasotraqueal. Estudio randomizado controlado The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial. Lim CW1, Min SW, Kim CS, Chang JE, Park JE, Hwang JY. Anaesthesia. 2014 Jun;69(6):591-7. doi: 10.1111/anae.12627. Epub 2014 Apr 18. Abstract During nasotracheal intubation, the tracheal tube passes through either the upper or lower pathway in the nasal cavity, and it has been reported to be safer that the tracheal tube passes though the lower pathway, just below the inferior turbinate. We evaluated the use of a nasogastric tube as a guide to facilitate tracheal tube passage through the lower pathway, compared with the 'conventional' technique (blind insertion of the tracheal tube into the nasal cavity). A total of 60 adult patients undergoing oral and maxillofacial surgery were included in the study. In 20 out of 30 patients (66.7%) with the nasogastric tube-guided technique, the tracheal tube passed through the lower pathway, compared with 8 out of 30 patients (26.7%) with the 'conventional' technique (p = 0.004). Use of the nasogastric tube-guided technique reduced the incidence and severity of epistaxis (p = 0.027), improved navigability (p = 0.034) and required fewer manipulations (p = 0.001) than the 'conventional' technique. PDF Calentamiento del tubo endotraqueal en intubación nasotraqueal a ciegas en cirugía maxilofacial Warming Endotracheal Tube in Blind Nasotracheal Intubation throughout Maxillofacial Surgeries. Hosseinzadeh H1, Taheri Talesh K2, Golzari SE3, Gholizadeh H2, Lotfi A4, Hosseinzadeh P5. J Cardiovasc Thorac Res. 2013;5(4):147-51. doi: 10.5681/jcvtr.2013.032. Epub 2013 Dec 5. Abstract INTRODUCTION: Blind nasotracheal intubation is an intubation method without observation of glottis that is used when the orotracheal intubation is difficult or impossible. One of the methods to minimize trauma to the nasal cavity is to soften the endotracheal tube through warming. Our aim in this study was to evaluate endotracheal intubation using endotracheal tubes softened by hot water at 50 deg;C and to compare the patients in terms of success rate and complications. METHODS: 60 patients with ASA Class I and II scheduled to undergo elective jaw and mouth surgeries under general anesthesia were recruited. RESULTS:success rate for Blind nasotracheal intubation in the control group was 70% vs. 83.3% in the study group. Although the success rate in the study group was higher than the control group, this difference was not statistically significant. The most frequent position of nasotracheal intubation tube was tracheal followed by esophageal and anterior positions, respectively. CONCLUSION:In conclusion, our study showed that using an endotracheal tube softened by warm water could reduce the incidence and severity of epistaxis during blind nasotracheal intubation; however it could not facilitate blind nasotracheal intubation. KEYWORDS: Anesthesia; Blind Intubation; Endotracheal Tube; Oral and Maxillofacial Surgery; Warming PDF Segundo Curso-Taller de Anestesia y Dolor Zapopan Jalisco, México Dic 1-2, 2016 Informes gmoarechiga@hotmail.com  California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

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