Proper utility of the nasogastric tube in assisting nasotracheal intubation

摘要

We have been using a nasogastric tube as an internal stylet to avoid trauma during nasotracheal intubation. Before intubation, we cut the proximal suction port of the nasogastric tube and lubricate it with a water-soluble jelly. We then introduce the nasogastric tube into the largest patent nares and thread it gently into the posterior pharynx. Once the nasogastric tube passes through the pharynx, the distal tip is retrieved in the oropharynx using a Ma gill's forceps and brought out through the mouth and held by the assistant. The proximal tip near the external nares is grasped by the intubating anesthesiologist and the tracheal tube is threaded over it. If an undue resistance is felt to the passage of tube, it is retrieved back for a short distance, followed by a forward pull on the nasogastric tube by the assistant which tends to bring the tip of tracheal tube forward and its easy advancement over the nasogastric tube.