A BUBBLE-TIP (AIRGUIDE(R)) TRACHEAL TUBE SYSTEM - ITS EFFECTS ON INCIDENCE OF EPISTAXIS AND EASE OF TUBE ADVANCEMENT IN THE SUBGLOTTIC REGION DURING NASOTRACHEAL INTUBATION

Epistaxis and tubal obstruction in the subglottic region are difficult ies encountered during nasotracheal intubation. Trauma to the nasal ai rway must be avoided, especially in patients receiving anticoagulant t herapy. In addition, smooth passage of the tracheal tube through the l arynx is desired. The tip of an Airguide(R) tracheal tube system has a soft, round, glossy balloon head which should be less traumatic to th e nasal mucosa than other more commonly used tubes. We, therefore, det ermined whether the Airguide(R) reduces the incidence of epistaxis and increases smooth passage of the tracheal tube in the subglottic regio n during nasotracheal intubation. Sixty-six patients were divided into two groups, Airguide(R) (n = 39) and Standard (n = 27). Each group wa s divided into two subgroups, topical epinephrine application as a muc osal decongestant and nonepinephrine. The incidences of epistaxis and smooth passage were compared between the two groups. The Airguide(R) g roup had a significantly lower incidence of epistaxis (9/39 vs 13/26; P < 0.05; bleeding was not checked in one patient in the Standard grou p) and provided a significantly smoother passage in the subglottic reg ion than the Standard group (tube impingement in the subglottic region , 0/39 vs 11/27; P < 0.01). There was no significant difference in the incidence of epistaxis between the subgroups with and without topical application of epinephrine. The Airguide(R) helps to minimize epistax is and increases navigability in the subglottic region during nasotrac heal intubation.