• Kwang Suk Seo, Jae-Hun Kim, Sol Mon Yang, Hyun Jeong Kim, Jae-Hyon Bahk, and Kwang Won Yum.
• Department of Dental Anesthesiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.
• Anesth. Analg. 2007 Nov 1;105(5):1420-4, table of contents.

BackgroundEpistaxis is the most common complication of nasotracheal intubation. We compared endotracheal tubes (ETT) obturated with an inflated esophageal stethoscope with normal ETTs with regard to the prevention of epistaxis and navigability, both with and without thermosoftening.MethodsDental surgical patients requiring nasotracheal intubation were randomly allocated into 1 of 4 groups (n = 50 each): Group 1, nonthermosoftened ETTs; Group 2, nonthermosoftened ETTs obturated with an inflated esophageal stethoscope; Group 3, thermosoftened ETTs; and Group 4, thermosoftened ETTs obturated with an inflated esophageal stethoscope. Navigability of ETTs through the nasal cavity and postintubation epistaxis were evaluated.ResultsNavigability of ETTs through the nasal cavity was the worst in Group 1 (P = 0.001). Epistaxis was the most severe in Group 1, similar between Groups 2 and 3, and the least severe in Group 4 (P < 0.001).ConclusionThe use of esophageal stethoscope-obturated ETTs was effective, and comparable to thermosoftening, in preventing epistaxis associated with nasotracheal intubation. Thermosoftened, obturated ETTs were more effective than simple thermosoftened ETTs in reducing epistaxis.

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