Frequency of epistaxis during nasotracheal intubation with or without vasoconstrictor drops in patients undergoing maxillofacial surgery

Background: nasotracheal intubation is a commonly performed procedure not only in patients undergoing oral and maxillofacial surgery but also as an airway management technique in patients with facial trauma or any other anatomical abnormality that makes orotracheal intubation impossible. most frequent complication encountered during this procedure is epistaxis. aim: to compare the frequency of epistaxis during nasotracheal intubation with or without xylometazoline drops in patients undergoing oral and maxillofacial surgery. study design: randomized controlled trial. methods: after informed consent,100 patients fulfilling the inclusion criteria were randomly allocated to group a who received 5 drops of xylometazolin 0.1% five minutes prior to intubation and group b in whom vasoconstrictor was not used. in both groups endotracheal tube was lubricated with lignocaine gel prior to insertion. epistaxis due to tube placement was assessed by an independent observer,2 minutes after intubation an 1 minute after extubation. results: frequency of epistaxis was 28% in xylomtazoline group,where as 76% patients in control group had it. conclusion: xylometazoline reduces frequency of epistaxis during nasal intubation.