プレフォーム経鼻気管チューブを用いた経鼻気管挿管における鼻腔誘導法の効果の比較：プロスペクティブ無作為化比較試験

Comparison of the Nasal Cavity Guidance Methods' Effects during Nasotracheal Intubation Using a Preformed Nasotracheal Tube: A Prospective Randomized Controlled Trial.

抄録

経鼻気管挿管は、主に顎顔面手術時に安全な気道を確保するために行われる。経鼻気管挿管を容易にし、合併症を減らすために、いくつかのガイド器具が提案されている。われわれは、手術室で容易に入手できる経鼻胃管と吸引カテーテルを用いて、経鼻気管挿管時の挿管条件の比較を試みた。この研究では、顎顔面手術を受けた患者114人を、経鼻胃管ガイド群（NG群）と吸引カテーテルガイド群（SC群）に無作為に分けた。主要アウトカムは総挿管時間であった。さらに、鼻出血の発生率と程度、挿管後の鼻腔内でのチューブの位置、鼻腔内での挿管中の操作回数についても調査した。鼻孔から口腔までの挿入時間および全挿管時間は、SC群がNG群より有意に短かった（< 0.001）。鼻出血の発生率はNG群で35.1％、SC群で43.9％と、従来報告されていた60～80％より低かったが、両群間に統計学的な差はなかった。経鼻気管挿管時の吸引カテーテル補助具の使用は、挿管時間を短縮し、合併症を増加させないので、効果的に使用できる。

Nasotracheal intubation is mainly performed to provide a safe airway during maxillofacial surgeries. Several guiding devices are suggested to facilitate nasotracheal intubation and reduce complications. We attempted to compare intubation conditions during nasotracheal intubation using a nasogastric tube and a suction catheter, which are readily available in operating rooms. In this study, 114 patients undergoing maxillofacial surgery were randomly divided into the nasogastric tube guidance group (NG group) and the suction catheter guidance group (SC group). The primary outcome was the total intubation time. Moreover, the incidence and degree of epistaxis, the position of the tube in the nasal cavity after intubation, and the number of manipulations during intubation in the nasal cavity were investigated. The insertion time from the nostril to the oral cavity and the total intubation time were significantly shorter in the SC group than in the NG group ( < 0.001). The incidence of epistaxis was lower at 35.1% in the NG group and 43.9% in the SC group than the previously reported 60-80%, but there was no statistical difference between the two groups. The use of a suction catheter aid during nasotracheal intubation can be used effectively because it shortens the intubation time and does not increase complications.