The Effect of Laryngeal View Grade and Intraoral Bleeding on Intubation Difficulty during Fiberoptic Nasotracheal Intubation

굴곡성 내시경을 이용한 경비기관내삽관 시 후두경으로 관찰한 후두시야(Laryngeal View) 등급과 구강내 출혈이 삽관의 난이도에 미치는 영향

Background: Nasotracheal intubation for general anesthesia is preferred for oral and maxillofacial procedures because it provides improved access to the operative site. Fiberopic nasotracheal intubation is a useful technique when airway management seems difficult. But, intaoral bleeding is considered as the important factor that makes fiberopic nasotracheal intubation difficult. The purpose of our study was to elucidate the effect of laryngeal view and bleeding on intubation difficulty during fiberopic intubation. Methods: We studied 461 patients undergoing nasotracheal intubation with permission. Laryngeal view grades were examined with laryngoscope and were recorded. Then, intubation time and the amounts of bleeding were measured during fibroptic nasotracheal intubation under general anesthesia. Results: There was no significant difference between laryngeal view grade and intubation difficulty (P > 0.05). But severity of bleeding increased intubation difficulty (P < 0.05). Conclusions: In this study, the significant amounts of bleeding had an effect on intubation difficulty.