Abstract：
UNASSIGNED: To evaluate the effectiveness of computed tomography-guided nasotracheal intubation procedure in predicting tube advancement difficulty and preventing epistaxis.
METHODS: The prospective study was conducted at Erciyes University Faculty of Dentistry from April 2018 to June 2019 and comprised maxillofacial surgery patients of either gender aged 18-50 years who were due to undergo bimaxillary orthognathic surgery, which was defined as American Society of Anaesthesiology grade I or II. The space where the tube was to be passed in the internal nasal valve region was measured horizontally and vertically using computed tomography. A single experienced anaesthesiologists intubated all the patients who were later divided into \'easy\' group A and \'difficult\' group B on the basis of the effort required to advance the tube through the nasal passage. Data was analysed using JASP version 0.14.1.0).
RESULTS: Of the 60 patients, 42(70%) were females and 18(30%) were males. The overall mean age was 29.0±10.5 years and the mean body mass index value was 23.6±4.0 kg/m 2 (p>0.05). There were 28(46.6%) patients in group A, and 32(53.3%) in group B. Median distances were significantly shorter and epistaxis was significantly higher in group B compared to group A (p<0.001). The cut-off values to reveal the distance at which difficulty may be experienced while advancing the tube, determined through receiver operating characteristic analysis, were 1.09 cm for vertical and 0.39cm for horizontal distances.
CONCLUSIONS: The nasotracheal intubation procedure under the guidance of computed tomography could help predict the difficulty of tube advancement, and could thus prevent epistaxis and other related nasal intubation complications. Clinical trial number: NCT05525754.
METHODS: The prospective study was conducted at Erciyes University Faculty of Dentistry from April 2018 to June 2019 and comprised maxillofacial surgery patients of either gender aged 18-50 years who were due to undergo bimaxillary orthognathic surgery, which was defined as American Society of Anaesthesiology grade I or II. The space where the tube was to be passed in the internal nasal valve region was measured horizontally and vertically using computed tomography. A single experienced anaesthesiologists intubated all the patients who were later divided into \'easy\' group A and \'difficult\' group B on the basis of the effort required to advance the tube through the nasal passage. Data was analysed using JASP version 0.14.1.0).
RESULTS: Of the 60 patients, 42(70%) were females and 18(30%) were males. The overall mean age was 29.0±10.5 years and the mean body mass index value was 23.6±4.0 kg/m 2 (p>0.05). There were 28(46.6%) patients in group A, and 32(53.3%) in group B. Median distances were significantly shorter and epistaxis was significantly higher in group B compared to group A (p<0.001). The cut-off values to reveal the distance at which difficulty may be experienced while advancing the tube, determined through receiver operating characteristic analysis, were 1.09 cm for vertical and 0.39cm for horizontal distances.
CONCLUSIONS: The nasotracheal intubation procedure under the guidance of computed tomography could help predict the difficulty of tube advancement, and could thus prevent epistaxis and other related nasal intubation complications. Clinical trial number: NCT05525754.
摘要：
■评估计算机断层扫描引导的鼻气管插管程序在预测导管推进困难和预防鼻出血方面的有效性。
方法：前瞻性研究于2018年4月至2019年6月在Erciyes大学牙科学院进行，研究对象包括18-50岁的任何性别的颌面手术患者，他们将接受双颌正颌手术。被定义为美国麻醉学学会一级或二级。使用计算机断层扫描水平和垂直地测量了要在内部鼻瓣区域中通过管的空间。一位经验丰富的麻醉师对所有患者进行了插管，这些患者后来根据将管通过鼻通道推进所需的努力分为“容易”A组和“困难”B组。使用JASP版本0.14.1.0)分析数据。
结果：在60名患者中，42（70％）为女性，18（30％）为男性。总体平均年龄为29.0±10.5岁，平均体重指数为23.6±4.0kg/m2（p>0.05）。A组28例(46.6%),B组32例（53.3%），与A组相比，B组的中位距离显著缩短，鼻出血显著增加（p<0.001）。截止值，以揭示在推进管时可能遇到的困难的距离，通过接收器工作特性分析确定，垂直距离为1.09厘米，水平距离为0.39厘米。
结论：计算机断层扫描引导下的经鼻气管插管程序有助于预测导管推进的难度，从而可以预防鼻出血和其他相关的鼻插管并发症。临床试验编号：NCT05525754。
方法：前瞻性研究于2018年4月至2019年6月在Erciyes大学牙科学院进行，研究对象包括18-50岁的任何性别的颌面手术患者，他们将接受双颌正颌手术。被定义为美国麻醉学学会一级或二级。使用计算机断层扫描水平和垂直地测量了要在内部鼻瓣区域中通过管的空间。一位经验丰富的麻醉师对所有患者进行了插管，这些患者后来根据将管通过鼻通道推进所需的努力分为“容易”A组和“困难”B组。使用JASP版本0.14.1.0)分析数据。
结果：在60名患者中，42（70％）为女性，18（30％）为男性。总体平均年龄为29.0±10.5岁，平均体重指数为23.6±4.0kg/m2（p>0.05）。A组28例(46.6%),B组32例（53.3%），与A组相比，B组的中位距离显著缩短，鼻出血显著增加（p<0.001）。截止值，以揭示在推进管时可能遇到的困难的距离，通过接收器工作特性分析确定，垂直距离为1.09厘米，水平距离为0.39厘米。
结论：计算机断层扫描引导下的经鼻气管插管程序有助于预测导管推进的难度，从而可以预防鼻出血和其他相关的鼻插管并发症。临床试验编号：NCT05525754。
