Comparison of cuff inflation-deflation technique and conventional technique for nasotracheal intubation using C-Mac video laryngoscope: A prospective randomised controlled trial.

Abstract

Background and aims: In traditional nasotracheal intubation (NTI), the tracheal tube is inserted through the nostril and manipulated in the pharynx to guide it into the trachea using additional maneuvers such as BURP (backward upward rightward pressure) maneuver, neck movement, tube rotation, the use of a bougie, or Magill's or Boedeker forceps under laryngoscopy guidance. These maneuvers often increase the time required for intubation, the risk of cuff rupture, and hemodynamic stress. The cuff inflation technique is an alternative NTI approach, where the cuff of the tube is inflated with air to help align with the tracheal opening.

Material and methods: All surgical patients requiring NTI were randomly allocated into two groups (n = 53 each): Group C, using the conventional intubation technique, and Group I, using the cuff inflation-deflation technique. Intubation time, types of maneuvers, number of maneuvers, hemodynamic response, percentage of glottic opening (POGO) score, and complications were evaluated.

Results: The cuff inflation technique required significantly less time for successful NTI compared to the conventional group (27.86 ± 4.47 s vs. 41.11 ± 10.98 s, respectively; P < 0.0001). Additionally, the number of accessory maneuvers required, hemodynamic stress responses, and complications were significantly reduced (P < 0.00277) with the cuff inflation technique compared to the conventional technique.

Conclusions: The cuff inflation method requires significantly less time for NTI compared to the conventional method. Additionally, the cuff inflation method facilitates faster alignment with the glottis inlet, reduces hemodynamic responses, minimizes the need for maneuverability, and results in fewer complications.