In order to identify if there were any studies describing the use of nasal trumpets during emergence of anesthesia in patients who have had nasal surgery, we used the keywords, terms, and phrases in combinations as follows: "nasal stent," "nasal trumpet," "nasopharyngeal trumpet," "nasopharyngeal airway stent," "nasopharyngeal airway tube," "nasopharyngeal obturator," or "nasopharyngeal tube" in conjunction with and without the keyword "anesthesia." The search strategy for PubMed/MEDLINE is as follows: (("nasal stent" OR "nasal trumpet" OR "nasopharyngeal trumpet" OR "nasopharyngeal airway stent" OR "nasopharyngeal airway tube" OR "nasopharyngeal obturator" OR "nasopharyngeal tube") AND (anesthesia)).
Because there were no published studies on the topic, we reasoned logically using our knowledge of the structures of the upper airway that could obstruct during anesthesia emergence, and we examined the various nasal trumpet sizes and types and evaluated how to properly position nasal trumpets against nasal splints in a manner that they could both fit into the nasal cavity.
For the Double Barrel Technique, two nasal trumpets are placed (one longer nasal trumpet and one shorter nasal trumpet) before the patient is extubated.
The steps for the Double Barrel Technique include (1) decongest the nose with oxymetazoline (if the patient did not undergo inferior turbinoplasty surgery), (2) place a layer of mupirocin ointment on the nasal trumpets, (3) place the longer nasal trumpet into the nostril in which there is more space available based on inferior turbinate size and presence of a nasal septal deviation, (4) place the smaller nasal trumpet into the nostril in which there is less space available, and (5) keep the nasal trumpets in place until the patient is in the postanesthesia care unit (PACU) and is alert enough to request the removal of the nasal trumpets, at which point they can be removed by sliding them out.
Beattie, "The modified nasal trumpet maneuver," Anesthesia and Analgesia, vol.
Zubair, "The use of nasal trumpet in a traumatic brain injury patient with obstructive sleep apnea," PM&R, vol.
He was administered racemic epinephrine, intravenous steroids, and heliox and fitted with bilateral nasal trumpets
. After 24 hours, the respiratory distress resolved, and the boy was transferred to the floor without any further problems.