RESUMO
OBJECTIVE: To assess superiority and safety of nasotracheal intubation with a thermal-softened tube guided by fiberoptic bronchoscope to establish an artificial airway for the institution of mechanical ventilation. METHODS: A total of 209 patients were randomly allocated to two groups: "treated tube" group (52 centigrade treated tube group, n=105), common tube group (the tube was prepared at room temperature 23-26 centigrade, n=104). Nasotracheal intubation was guided by a fiberoptic bronchoscope to establish an artificial airway. RESULTS: (1)The required time of the first successful nasotracheal intubation in the "treated tube" group [(14.48+/-8.31) seconds, 99 cases] was significantly shorter than in the common tube group [(23.85+/-11.97) seconds, 96 cases, P<0.01]. (2)Ratio of successful intubation in the "treated tube" group under conscious condition was higher than that of the common tube group [100% (28/28 cases) vs. 87.5% (21/24 cases), P<0.05]. (3) Ratio of successful intubation in 30 seconds in the "treated tube" group was significantly higher than that of the common tube group [93.9% (93/99 cases) vs. 68.6% (66/96 cases), P<0.01]. (4)The incidence of difficult intubation in the "treated tube" group [5.05% (5/99 cases)] was significantly lower than that of the common tube group [32.29%, (31/96 cases), P<0.01]. (5)The incidence of epistaxis in the first successful nasotracheal intubation in the "treated tube" group [4.0% (4/99 cases)] was significantly lower than that of the common tube group [15.6%,(15/96 cases), P<0.01]. (6)The incidence of epistaxis during nasotracheal intubation in conscious patients was lower in the "treated tube" (3.6%, 1/28 cases) group than that of the common tube group [28.6%, (6/21 cases), P<0.05]. CONCLUSION: The use of a thermal-softened nasotracheal tube to intubate guided by a fiberoptic bronchoscope to establish an artificial airway shortened preparation time before intubation. It is not necessary to use a vasoconstrictor for nasal mucosa before intubation, therefore cardiovascular effects due to the drugs can be avoided. It increases the willingness of conscious patients to accept the procedure and successful rate of the first intubation.
