J-Shaped Guidewire-Assisted Nasotracheal Intubation in the Dental Treatment of Children-A Retrospective, Observational Study.

BACKGROUND

The challenges of nasotracheal intubation (NTI) often arise from the misalignment of the oral, pharyngeal, and laryngeal axes. We sought to assess the success and complication rate of an economically reusable J-shaped stainless-steel guidewire for NTI during dental treatment in children.

MATERIALS AND

METHODS

Pediatric patients undergoing dental treatment under general anesthesia who were nasally intubated during January 2016-December 2023 were retrospectively analyzed. The following variables were collected: details of relative position between endotracheal tube (ETT) tip and glottis, peri-intubation vital signs, and incidence of related complications. The primary observation indicator was the bullseye probability, defined as the probability of the ETT directly aligning with the glottis after glottic exposure.

RESULTS

Data were obtained from 692 pediatric patients. The bullseye probability was 49.4%. The probability of ETT tip pointing toward the tongue base was 11.3%, and the probability of ETT tip pointing toward the esophageal entrance was 1.9%. The probability of ETT tip being at the same horizontal plane with glottis was 86.8%. Additional assistance was required to advance the tube smoothly in 48.4% of cases. The total intubation time was 63.1 (Q1-Q3, 54.3-72.3) s with a 100% overall success rate. The incidence of severe lip and mucosal trauma was 0.7%.

CONCLUSIONS

The J-shaped stainless-steel guidewire is a suitable and economic auxiliary tool to assist NTI for outpatient dental procedures in children. The occurrence of severe lip and mucosal trauma was lower than reported in other studies.