Less postoperative sore throat after nasotracheal intubation using a fiberoptic bronchoscope than using a Macintosh laryngoscope: A double-blind, randomized, controlled study

Abstract

Study objective: To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat.

Design: Prospective, double-blinded, randomized, and controlled study.

Setting: Postoperative areas and surgical ward of a university hospital.

Patients: Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation.

Interventions: Patients were randomized to one of two intubation groups, F (fiberoptic bronchoscope-guided) and M (Macintosh laryngoscope-guided), and after induction of general anesthesia, the patients' tracheas were intubated via the nose.

Measurements: The intensity of postoperative sore throat was evaluated using a numerical rating score (0=none, 10=severe) at 24 hours postoperatively, and the incidence of nasal mucosal trauma, time to completion of intubation, and hemodynamic responses were recorded and compared between groups.

Main results: The numerical rating score value was significantly lower in group F than in group M (P=.0047), but the incidence of nasal mucosal trauma was comparable between the two groups. The median time to completion of intubation was shorter for group F than group M (P<.0001). Hemodynamic responses were not significantly different.

Conclusions: Fiberoptic bronchoscope-guided intubation is associated with less sore throat after nasotracheal intubation than M intubation. The time to completion of intubation was significantly shorter using the fiberoptic bronchoscope than that using the Macintosh laryngoscope.

Keywords: Fiberoptic bronchoscope;; Macintosh laryngoscopes; Nasotracheal intubation;; Postoperative sore throat;.