– The airway is first secured orally before nasal intubation
– The introducer and flexible reinforced airway tubing used for nasal intubation are recognised to reduce complications of nasal intubation
– The flexible reinforced endotracheal tube allows nasal intubation through the lower safer nasal passage
– post operative nausea and vomiting
– post operative sore throat
– coughing on emergence
– haemodynamic instability
– anaesthetic requirements
– recovery time for day surgery
The distal end of the flexible reinforced airway tubing having the same diameters of the airway tubing of the laryngeal mask with a standard 15mm connector at the proximal end is connected with a smooth, tapered, curved and blunt ended introducer is passed through the most patent nostril. The Introducer and is grasped and delivered through the mouth with Magill’s forceps and once approximately 5cm of the airway tubing protrudes from the lips the introducer is removed.
The anaesthetic circuit is now removed from the oral laryngeal mask and connected to the proximal end of the nasal airway tubing. The 15mm connecter is removed from the oral laryngeal mask airway tubing and joined to the distal end of the airway tubing protruding through the mouth. This allows for continued patient ventilation and maintained anaesthesia.
The airway tubing of the laryngeal mask is stabilized in the oro-pharynx and the redundant airway tubing of the joined laryngeal mask and nasal airway tubing is reduced by gentle traction on the nasal airway tubing distal to the nares.
Once satisfied that the laryngeal mask is in the correct position and ventilation is maintained the nasal airway tubing is disconnected from the laryngeal mask tubing and the 15mm connector is reinserted in the laryngeal mask airway tubing and reconnected to the airway circuit. The original oral laryngeal mask is now reconfigured as a nasal laryngeal mask.
|Flexible Nasal Laryngeal Mask Airway