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Randomized Controlled Trial
. 2019 Aug 23;19(1):163.
doi: 10.1186/s12871-019-0834-3.

A comparison between the Disposcope endoscope and fibreoptic bronchoscope for nasotracheal intubation: a randomized controlled trial

Junma Yu  1   2 , Rui Hu  3 , Lining Wu  3 , Peng Sun  3 , Zhi Zhang  4
Affiliations
Randomized Controlled Trial

A comparison between the Disposcope endoscope and fibreoptic bronchoscope for nasotracheal intubation: a randomized controlled trial

Junma Yu et al. BMC Anesthesiol. .

Abstract

Background: Nasotracheal intubation (NTI) is frequently performed for oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fibreoptic bronchoscopy.

Methods: Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fibreoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. The NTI time, which was defined as the time from when the fibreoptic bronchoscope or aseptic suction catheter was inserted into the nasal cavity to the time at which the tracheal tube was correctly inserted through the glottis, was recorded. Epistaxis was evaluated by direct laryngoscopy five minutes after completing NTI and was scored as one of four grades according to the following modified criteria: no epistaxis, mild epistaxis, moderate epistaxis, and severe epistaxis.

Results: The time to complete NTI was significantly longer in the fibreoptic group than in the Disposcope group (38.4 s vs 24.1 s; mean difference, 14.2 s; 95% confidence interval (CI), 10.4 to 18.1). Mild epistaxis was observed in 8 patients in the fibreoptic group and in 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9), though no moderate or severe epistaxis occurred in either group. Furthermore, no obvious nasal pain was reported by any of the patients at any time point after extubation (P = 0.74).

Conclusion: NTI can be completed successfully using either fibreoptic bronchoscopy or Disposcope endoscope as a guide without any severe complications. However, compared to fibreoptic bronchoscopy, Disposcope endoscope requires less execution time (the NTI time).

Trial registration: This clinical research was registered at the Chinese Clinical Trial Registry ( www.chictr.org.cn , ChiCTR-IPR-17011462, date of registration, May 2017).

Keywords: Disposcope endoscope; Endotracheal tube; Fibreoptic; Nasotracheal intubation; Video stylet.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The Disposcope endoscope (Dexscope™, Yangzhou Dex Medical Device Co., Ltd., Yangzhou, China, a). The depth of wire transfer was pre-measured to ensure that the wire tip did not exceed the tube before NTI. (b) An aseptic suction catheter (OD, 5.33 mm, TUORen Medical Equipment Co., Henan, China, c and d) was inserted through the tracheal tube (TUORen Medical Equipment Co., Henan, China) and fibreoptic bronchoscope (Pentax FI-10BS, Pentax Corporation, Tokyo, Japan, d)
Fig. 2
Fig. 2
The entire process for nasotracheal intubation using the Disposcope endoscope (a-f). (a) The wire tube body was bent along the radian of the nasal cavity. (b and c) The tracheal tube was inserted through the nasopharynx under suction catheter guidance until the placement depth reached 15 cm. (d-f) The suction catheter was withdrawn, and NTI was then performed under the guidance of the Disposcope endoscope
Fig. 3
Fig. 3
Flow chart illustrating the recruitment and loss of patients in the fibreoptic group and Disposcope group
See this image and copyright information in PMC

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