Effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation under direct laryngoscopy: Randomized controlled trial

Abstract

The aim of the study is to compare the effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation NTI under direct laryngoscopy.After taking permission from institutional ethical committee, patients of 18-60 years of either sex of ASA grade I and ll were divided into groups of 40 each. In group C, cuff inflation technique and in group M, Magill forceps technique was used for navigating the endotracheal tube from oropharynx to glottic opening to achieve intubation. Parameters observed were time required for intubation, attempts of intubation, injury occurring to oropharyngeal structures during intubation and hemodynamic parameters. Cuff of endotracheal tube was assessed postoperatively for any leaksAnalysis of the data for the various parameters was done using paired t-test for intra-group comparison and student t-test for intergroup comparison and chi-square test was used for qualitative (non parametric) data.There was no significant difference in demographic parameters, time required for intubation, number of attempts for intubation and hemodynamic parameters, but trauma to oropharyngeal structures was more in group M (8/40) compared to group C (0/40). (p≤0.05) Trauma to cuff of endotracheal tube was seen in group M (1/40) while none in group C (0/40) which was statistically not significant (p≤0.05).Thus, Cuff inflation technique can be used as an effective alternative to Magill forceps for oropharyngeal navigation of endotracheal tube under direct laryngoscopy guided nasotracheal intubation in patients with normal airways.