EPISTAXIS AND NASOTRACHEAL INTUBATION - PREVENTION WITH VASOCONSTRICTOR SPRAY

Eighty patients having anaesthesia for oral surgery requiring nasal in tubation were randomly allocated to be intubated with either a plain M agill red rubber or cuffed polyethylene endotracheal tube and in a dou ble blind manner, to receive xylometazoline 0.1% vasoconstrictor nasal spray. The extent of any epistaxis occurring was assessed by an indep endent observer. With the Magill tube there was bleeding in one out of twenty patients in both the vasoconstrictor group and non vasoconstri ctor group at intubation and no bleeding in either of the two groups a t extubation. With the polyethylene tube sixteen out of twenty patient s had bleeding in the non vasoconstrictor group. This improved to seve n out of twenty with the administration of vasoconstrictor drops at in tubation (chi square 10.2; p<0.01) in the polyethylene tube group. At extubation ten out of twenty patients had bleeding in the non vasocons trictor group improving to two out of twenty with the administration o f the vasoconstrictor (chi square 9.6; p,0.01). The use of the vasocon strictor xylometazoline helped to reduce epistaxis that occurred durin g nasal intubation and further study into the type of endotracheal tub e is recommended.