Low dosage sufentanil for blind nasotracheal intubation / 实用口腔医学杂志

Objective:To evaluate the effects of low dosage sufentanil used for blind nasotracheal intubation.Methods:Sixty cases for maxillofacial surgery were divided into 3 groups randomly with 20 in each group. Patients in groupⅠwere administered with fentanyl and midazolam by vein, those in groupⅡ with fentanyl and droperidol by vein,those in group Ⅲ with sufentanil at 0.1~0.2 ?g/kg. Intramuscular premedication of atropine-midazolam and blind nasotracheal intubation were performed in all cases after surface anesthesia for routine. Blood pressure(BP), heart rate (HR), mean artery pressure (MAP), blood oxygen saturation of pulse (SpO_2), intubation complication(IC), intubation achievement ratio(IAR), sedation score (Ramsay score), patient satisfaction(PS), and the incident rate of amnesia(IRA) in the three groups at T1 (before administering drug), T2 (after administering drug) and T3 (when tracheal tube was inserted into tracheal) were measured and observed. Results:In groups I and Ⅱ Ramsay score increased to 3～5, MAP and SpO_2 decreased (P0.05).Conclution:The low dose sufentanil can be applied for the sedation and analgesic before blind nasotracheal intubation.

Tracheal Tube Cuff Inflation in Oropharynx : An Useful Method in Blind Nasotracheal Intubation / 대한마취과학회지

We designed a study to determine if the tracheal tube cuff inflation in the oropharynx improves the success rate of blind nasotracheal intubation in normal, paralyzed patients because of lacking of controlled study about it. In prospective, randomized fashion, 100 ASA I or II patients undergoing elective oral surgery were studied. The trachea was intubated once keeping the tracheal tube cuff deflated throughout the maneuver and once using the technique of tracheal tube cuff inflation in the oropbarynx. A maximum of two attempts was allowed for each technique. If the first attempt was failed, the second attempt was tried with an addition of application of thyroid cartilage compression in each technique. Witb the tracheal tube cuff inflated, the success rate was significantly higher than the cuff-deflated technique(p<0.05). A application of thyroid cartilage compression increased the success rate of the blind nasotracheal intubation in each technique, but it was more useful in the cuff inflation technique(p<0.05). Time taken to intubate the trachea was longer in the cuff inflation technique. We suggest that, in normal paralyzed patients, the tracheal tube cuff inflation in the oropharynx increases the success rate of blind nasotracheal intubation.

Clinical experience of blind nasotracheal intubation for conscious patient / 대한마취과학회지

Blind nasotrscheal intubation with preformed tube has been attempted in 20 conscious young male scheduled for surgical reduction of mandibular fracture. The patient was premedicated in the usual fashion with glycopyrrolate -midszolam- fentanyl. Airway anesthesia was performed with topical lidocaine ; Nasopharyngeal and translaryngeal. Of the 20 patients in whom intubation was performed, 12 (60%) required one to three attempts, 6 (30%) required four to six, and only two failures occurred. Contrary to our expectation, this procedure met with almost positive acceptance by the patients in the series, and the surgical staff had no adverse criticism. In addition to the effectiveness and ease of learning, this technique is simple and free from major morbidity.