Related Experiment Video
Updated: Jul 2, 2026
Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine
Published on: August 25, 2022
A Plastic Film Guiding Sheath (PFGS) Reduces Epistaxis in Patients Undergoing Nasotracheal Intubation: A Prospective,
Background:
Epistaxis caused by nasal mucosal damage is the most common complication of nasotracheal intubation. It is unclear whether a plastic film guiding sheath (PFGS) can reduce epistaxis during nasotracheal intubation.
Purpose:
The purpose of this study was to develop a new technique (PFGS) and compare the frequency of epistaxis in patients undergoing nasotracheal intubation with or without PFGS.
Study Design, Setting, Sample:
A double-blinded randomized controlled trial was conducted. Patients admitted to the Second Xiangya Hospital from January to March 2025 for maxillofacial surgery requiring nasotracheal intubation were enrolled. Exclusion criteria included previous nasal surgery or trauma, recurrent epistaxis, coagulopathy or ongoing anticoagulant therapy, expected difficult intubation, and other conditions deemed unsuitable for clinical trials.
Predictor Variable:
The predictor variable was nasotracheal intubation technique. Subjects were randomly allocated into 2 groups: PFGS group (PFGS isolation-assisted nasotracheal intubation) and conventional group (conventional nasotracheal intubation).
Main Outcome Variables:
The primary outcome variable was epistaxis (yes/no). Five minutes after intubation completed, an investigator blinded to group allocation entered the operating room and evaluated the epistaxis.
Covariates:
The covariates were subjects' height, weight, age, sex, nasal symptoms, history of smoking, nasal abnormalities, coagulation function, and intubation characteristics.
Analyses:
T-test or χ2 test was selected as needed to compare the demographic data and intubation characteristics of 2 groups. Fisher's exact test was used to compare the epistaxis of 2 groups. A stepwise logistic regression was performed to assess the effect of intubation technique on epistaxis. Significance for all results was set at P < .05.
Results:
The final sample was composed of 63 subjects: 31 (49.2%) in the PFGS group and 32 (50.8%) in the conventional group, including 57 (90.5%) men and 6 (9.5%) women, with a mean age of 49.3 ± 11.3 years. The frequency of epistaxis was 6.45% (2) in the PFGS group and 40.63% (13) in the conventional group (P < .05). The relative risk of epistaxis was 0.159 (0.039, 0.647) in the PFGS group compared to the conventional group.
Conclusions And Relevance:
This study's results suggest that using the PFGS to assist nasotracheal intubation can reduce the frequency of epistaxis.
