Comparison of Intubation Time and Epistaxis Between Left Versus Right Nostril Approaches for Flexible Intubation Video Endoscope-guided Pediatric Nasotracheal Intubation
10.11714/jsysu.med.YX20260031
- VernacularTitle:可视插管软镜引导下儿童经鼻气管插管左、右鼻孔入路的插管时间及鼻出血的比较
- Author:
Kun YUE
1
;
Jingru WANG
1
;
Yuanling XU
1
;
Yin XIA
1
;
Yingying SUN
1
Author Information
1. Department of Anesthesiology and Perioperative Medicine， Anhui Provincial Children’s Hospital， Hefei 230051， China
- Publication Type:Journal Article
- Keywords:
nasotracheal intubation;
flexible intubation video endoscope;
pediatric anesthesia;
epistaxis;
nostril selection;
airway management
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(4):730-738
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveCurrently， evidence regarding whether the left or right nostril should be preferentially selected for nasotracheal intubation （NTI） in children remains insufficient， particularly under continuous visualization conditions. This study aimed to compare the efficiency and safety of NTI via the left versus right nostril in children under flexible intubation video endoscope （FIVE） guidance. MethodsA total of 100 children aged 3-7 years with American Society of Anesthesiologists physical status I-II， who were scheduled for elective dental caries treatment under general anesthesia， were randomly assigned to undergo FIVE-guided NTI via either the left nostril （group L） or the right nostril （group R）. The primary outcome was intubation time. Secondary outcomes included first-attempt success rate， number of intubation attempts， incidence and severity of epistaxis， peri-intubation hemodynamic and respiratory parameters， and postoperative procedure-related complications （nasal blockage， sore throat， and hoarseness）. ResultsNo statistically significant between-group difference was found in intubation time （L group： 36.86 ± 6.04 s vs. R group： 37.96 ± 6.20 s； P=0.371） or first-attempt success rate （96% vs. 92%， respectively； P=0.400）. The incidence and severity of epistaxis were comparable between groups （10% vs. 12%； P=0.749）. No statistically significant between-group differences were observed in hemodynamic and respiratory parameters at all measured time points （all P>0.05）. The incidences of postoperative nasal congestion， sore throat， and hoarseness were low in both groups. ConclusionIn children undergoing FIVE-guided NTI， tracheal catheter insertion via the left or right nostril yields comparable efficacy and safety. When using visualization-guided techniques in routine pediatric clinical practice， nostril laterality does not need to be prioritized when selecting the insertion side for NTI.
