To the Editor:--Cox recommended suctioning the nasopharynx before nasotracheal intubation in children to prevent nasal secretions from entering the tracheal tube and possibly the lungs. The following procedure may be used also. The tip of a suction catheter is inserted beyond the distal end of the endotracheal tube. This permits transit through the nasal passage without the tube filling with secretions. If secretions are visualized in the nasopharynx, suction is applied. After tracheal intubation, the catheter is removed while suction is applied to avoid possible contamination with secretions. This procedure is easy and fast and prevents tracheal tube occlusion and lung contamination with nasopharyngeal secretions.

Saussine Max, M.D., Departement d'anesthesie-reanimation B, Hopital Arnaud de Villeneuve, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier, France

(Accepted for publication July 9, 1995.)

Cox RG: Nasotracheal intubation in children. ANESTHESIOLOGY 82:1085, 1995.