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Perioperative use of the modified nasal trumpet in 346 patients
1Department of Anesthesiology, Drexel University College of Medicine, Philadelphia, USA. Samuel.Metz@Drexel.edu
Background:
The modified nasal trumpet (MNT) is a prepackaged nasopharyngeal airway modified with distal holes and fitted with a 15 mm adaptor allowing connection to an anaesthesia circuit. It may be useful for airway management during anaesthesia.
Methods:
After applying a spray to constrict the nasal mucosa, we used the MNT in 346 spontaneously breathing patients for three indications: alone as an airway device during general anaesthesia, to provide supplemental oxygen immediately after extubation instead of by facemask, and to facilitate fibreoptic intubation during general anaesthesia.
Results:
The device was successful for giving supplemental oxygen after extubation (n=244) and facilitating fibreoptic intubation (n=28). When used as an airway for general anaesthesia, it was only successful without manipulation in 33 of 74 patients (45%). The MNT was easy to insert in awake patients. We encountered six complications: one MNT folded in the pharynx, and five patients (1.4%) experienced nosebleeds.
Conclusions:
The MNT was disappointing as a primary airway device under general anaesthesia but was useful for giving oxygen after extubation and for facilitation of fibreoptic intubation. It can cause nosebleeds.
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