Comparative Hemodynamic Effects of Nasal versus Oral Endotracheal Intubation in Children Undergoing Adenotonsillectomy: An Observational Study

Background: Adenotonsillectomy is a common pediatric surgical procedure. Endotracheal intubation can be performed via nasal or oral routes. This study compares hemodynamic outcomes between nasal and oral intubation in children undergoing adenotonsillectomy. Methods: This prospective, randomized controlled trial enrolled 100 children (ages 3-12) undergoing adenotonsillectomy. Patients were randomly assigned to nasal (n=50) or oral (n=50) endotracheal intubation. Hemodynamic parameters (heart rate, blood pressure, oxygen saturation) were recorded pre-intubation, post-intubation, and intraoperatively. Results: Nasal intubation resulted in: Significantly lower heart rate (p<0.01), Reduced systolic blood pressure (p<0.05), Increased oxygen saturation (p<0.05) compared to oral intubation. Intraoperative hemodynamic stability was similar between groups. Conclusion: Nasal endotracheal intubation in children undergoing adenotonsillectomy results in improved hemodynamic profiles, with reduced heart rate and blood pressure, and increased oxygen saturation. These findings support nasal intubation as a viable and potentially beneficial approach in pediatric adenotonsillectomy. Key words: adenotonsillectomy, pediatric, anaesthesia, intubation, hemodynamics.