Clinical Investigations : A Prospective Study on Complications after Nasotracheal Intubation in Oral and Maxillofacial Surgery Patients

Background : Nasotracheal intubation is commonly and safely used in the anesthetic management of patients undergoing head and neck surgeries. There are some kinds of reports about complications associated with nssotracheal intubation which are related to long intubation period in the intensive care unit. But there are few reports about complications after nasotracheal intubation in surgery patients. A prospective study was carried out to evaluate the incidence and outcome of complications of nasotracheal intubation in oral and maxillofacial surgery patients in the Seoul National University Dental Hospital. Methods : We studied 317 nasally intubated patients over 8 months. Endotracheal tubes softened by soaking in hot nonnal saline were used. After general anesthesia, we followed the hospital course of patients from the view point of the incidence and outcome of complications associated with nasotracheal intubation. Results: The overall complication rate was 27.1%. Nasal bleeding and benign nasal obstruction were the most frequent events, accounting for a mean of 15.5% and 9.8%, respectively. Other low incidence complication was ulceration of the nose, None of the complications were fatal or resulted in serious sequelae. There was a slight relationship between complications and age or intubation period. Conclusions : These results suggest that short term use of nasotracheal intubation may be as safe as orotracheal intubation. Complications may be associated with elderly patients and long intubation duration over than 24 hours in surgery patients. (Korean J Anesthesiol 2000; 39: 72~76