Background: Clinicians sometimes encounter resistance in advancing a tracheal tube, which is inserted via a nostril,\nfrom the nasal cavity into the oropharynx during nasotracheal intubation. The purpose of this study was to\ninvestigate the effect of neck extension on the advancement of tracheal tubes from the nasal cavity into the\noropharynx during nasotracheal intubation.\nMethods: Patients were randomized to the â??neck extension group (E group)â?? or â??neutral position group (N group)â??\nfor this randomized controlled trial. After induction of anesthesia, a nasal RAE tube was inserted via a nostril. For the\nE group, an anesthesiologist advanced the tube from the nasal cavity into the oropharynx with the patientâ??s neck\nextended. For the N group, an anesthesiologist advanced the tube without neck extension. If the tube was\nsuccessfully advanced into the oropharynx within two attempts by the same maneuver according to the assigned\ngroup, the case was defined as â??success.â?? We compared the success rate of tube advancement between the two\ngroups.\nResults: Thirty-two patients in the E group and 33 in the N group completed the trial. The success rate of tube\npassage during the first two attempts was significantly higher in the E group than in the N group (93.8% vs. 60.6%;\nodds ratio = 9.75, 95% CI = [1.98, 47.94], p = 0.002).\nConclusion: Neck extension during tube advancement from the nasal cavity to the oropharynx before\nlaryngoscopy could be helpful in nasotracheal intubation.
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