Epistaxis and nasotracheal intubation--prevention with vasoconstrictor spray

Irish Journal of Medical Science
J O'Hanlon, K W Harper

Abstract

Eighty patients having anaesthesia for oral surgery requiring nasal intubation were randomly allocated to be intubated with either a plain Magill red rubber or cuffed polyethylene endotracheal tube and in a double blind manner, to receive xylometazoline 0.1% vasoconstrictor nasal spray. The extent of any epistaxis occurring was assessed by an independent observer. With the Magill tube there was bleeding in one out of twenty patients in both the vasoconstrictor group and non vasoconstrictor group at intubation and no bleeding in either of the two groups at extubation. With the polyethylene tube sixteen out of twenty patients had bleeding in the non vasoconstrictor group. This improved to seven out of twenty with the administration of vasoconstrictor drops at intubation (chi square 10.2; p < 0.01) in the polyethylene tube group. At extubation ten out of twenty patients had bleeding in the non vasoconstrictor group improving to two out of twenty with the administration of the vasoconstrictor (chi square 9.6; p,0.01). The use of the vasoconstrictor xylometazoline helped to reduce epistaxis that occurred during nasal intubation and further study into the type of endotracheal tube is recommended.

References

Sep 1, 1989·Anesthesiology·R Cooper
Aug 1, 1973·Archives of Otolaryngology·R B Smith
Mar 24, 2009·Anaesthesia·C JanakiramanI P Latto
Nov 15, 1930·British Medical Journal·I W Magill

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Citations

Jan 23, 2003·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Shaukat Mahmood, Terrence Lowe
Jun 1, 1997·Acta Anaesthesiologica Scandinavica·P Dost, W Armbruster
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May 23, 2012·Journal of Clinical Anesthesia·Hyung-Sun LimSeonghoon Ko
Jun 29, 2018·Anesthesia Progress·Yoshihiro TakasugiSatoshi Morishita
Jun 1, 2016·Journal of Dental Anesthesia and Pain Medicine·Seong In ChiKwang-Suk Seo
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Aug 29, 2020·Annals of Maxillofacial Surgery·Vinay R DhakateHarshvardhan S Bharadwaj
Oct 4, 2020·European Journal of Anaesthesiology·Dongwook WonTae Kyong Kim
Nov 17, 2020·Journal of Dental Anesthesia and Pain Medicine·Seung-Hyun RheeKwang-Suk Seo

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