Suction Catheter as a Guide for Nasotracheal Intubation Under General Anesthesia

NCT ID: NCT05717907

Last Updated: 2024-12-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-05

Study Completion Date

2024-06-10

Brief Summary

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The goal of this clinical trial to study the efficacy of suction catheter guided technique and conventional technique during nasotracheal intubation.

The main question are

* How effective of the use of a suction catheter guided ETT in reducing bleeding during nasotracheal intubation?
* Does the use of a suction catheter guided ETT can improve its navigability through the nasal passage and reduce nasal passage time?

Detailed Description

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Study design Clinical trial: Prospective randomized controlled trial with equal randomization (1:1), double-blinded (Participant and Primary outcome assessor), parallel design

Conditions

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Intubation Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Control group

conventional nasotracheal intubation procedure

Group Type NO_INTERVENTION

No interventions assigned to this group

Guided group

use suction catheter guided endotracheal tube through the nasal passage

Group Type EXPERIMENTAL

suction catheter

Intervention Type DEVICE

a suction catheter will be first inserted through the ETT so that about 10 cm of the catheter was protruding from the distal end of the tube. The tip of the catheter is then inserted through the selected nostril until it passes to the pharynx. If resistance is felt to the passage of catheter, the other nostril will be tried. The nostril with less resistance to the catheter passage will be chosen for the completion of the procedure. The Endotracheal tube is then advance over the catheter through the nasal passage while holding the catheter proximal to the tube to prevent its advancement with the tube. After the tube tip reach to the pharynx, the suction catheter is withdrawn and tracheal intubation will be completed.

Interventions

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suction catheter

a suction catheter will be first inserted through the ETT so that about 10 cm of the catheter was protruding from the distal end of the tube. The tip of the catheter is then inserted through the selected nostril until it passes to the pharynx. If resistance is felt to the passage of catheter, the other nostril will be tried. The nostril with less resistance to the catheter passage will be chosen for the completion of the procedure. The Endotracheal tube is then advance over the catheter through the nasal passage while holding the catheter proximal to the tube to prevent its advancement with the tube. After the tube tip reach to the pharynx, the suction catheter is withdrawn and tracheal intubation will be completed.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient undergoing elective oral and maxillofacial surgery in which nasotracheal intubation is preferred over orotracheal intubation to optimize surgical access.
* ASA physical status I-II
* Thai adult, aged 18-65 years old
* Normal Body Mass Index (BMI = 18.5-24.9)

Exclusion Criteria

* Anticipated difficult airway (e.g., Mallampati classification 3-4, interincisal distance \< 35 mm., thyromental length \< 60 mm., limited neck mobility)
* Nasal infection or systemic infection
* Abnormal coagulation status or having bleeding disorder or taking anticoagulation/antiplatelet medication
* History of recurrent epistaxis since adulthood
* Allergic rhinitis that necessitates the use of glucocorticoids, antihistamine, antileukotriene or decongestant in the past 4 weeks
* History of nasal trauma or abnormality (e.g., trauma in mid-face region, nasal surgery, nasal polyps, chronic sinusitis, abnormal nasal vasculature, tumor in nasal region, radiotherapy in nasal region)
* Craniofacial deformity syndrome
* Using nasal oxygen or Continuous Positive Airway Pressure (CPAP)
* Previous nasotracheal intubation or nasogastric tube placement within 3 months
* Diagnosed as having a mental disorder

Drop-out criteria:

* Unable to complete intubation procedure
* Intubation failed on both nostrils
* When intubation was only possible with a tube smaller than 6.5 internal diameter (ID) in male and 6.0 ID in female
* Inadequate data collection
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mahidol University

OTHER

Sponsor Role lead

Responsible Party

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Duangdee Rummasak

Assoc. Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Duangdee Rummasak, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mahidol University

Locations

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Faculty of Dentistry

Ratchathewi, Bangkok, Thailand

Site Status

Countries

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Thailand

References

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Anwer HM.F., Ibrahim AA. Suction catheter guidance of the endotracheal tube to facilitate nasal intubation: a double blind, randomized clinical trial. MEJA.2018;25 (2):155-63.

Reference Type BACKGROUND

Prasanna D, Bhat S. Nasotracheal Intubation: An Overview. J Maxillofac Oral Surg. 2014 Dec;13(4):366-72. doi: 10.1007/s12663-013-0516-5. Epub 2013 May 1.

Reference Type BACKGROUND
PMID: 26224998 (View on PubMed)

Jongcharoenkamon I, Juajarn T, Pisilp N. Does suction tube guiding reduce epistaxis from nasotracheal intubation? Mahasarakham Hospital Journal. 2020;17(3):210-7.

Reference Type BACKGROUND

Kim YC, Lee SH, Noh GJ, Cho SY, Yeom JH, Shin WJ, Lee DH, Ryu JS, Park YS, Cha KJ, Lee SC. Thermosoftening treatment of the nasotracheal tube before intubation can reduce epistaxis and nasal damage. Anesth Analg. 2000 Sep;91(3):698-701. doi: 10.1097/00000539-200009000-00038.

Reference Type BACKGROUND
PMID: 10960403 (View on PubMed)

Piepho T, Thierbach A, Werner C. Nasotracheal intubation: look before you leap. Br J Anaesth. 2005 Jun;94(6):859-60. doi: 10.1093/bja/aei146. Epub 2005 Apr 15.

Reference Type BACKGROUND
PMID: 15833776 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2023/DT039

Identifier Type: -

Identifier Source: org_study_id