Inflation-deflation Method for Nasal Intubation in Pediatric Patients

the investigator will compare the cuff inflation‐deflation method versus the conventional method of nasal intubation in pediatric patients for the need of using Magill forceps 90 pediatric patients between the ages of 3 and 12 years with the American Society of Anesthesiologists (ASA) physical status I‐II, scheduled for elective surgery (dental and maxillofacial) will be enrolled in a prospectively randomized observer‐blinded clinical trial. Patients, who have coagulopathies, have upper airway abnormalities, at risk for aspiration or by reasons of parent's refusal will be excluded from the study. Airway management is subdivided into phases: ‐ Phase 1: Passage of the endotracheal tube through the nose into the pharynx ‐ Phase 2: Video‐laryngoscope‐guided passage of the endotracheal tube through the pharynx into the trachea. Phase 2 can be performed with the tracheal tube cuff inflation‐deflation method vs. non‐cuff inflation method. A Magill forceps can be used to guide the endotracheal tube pass through the pharynx and glottis into the trachea if required. Tracheal tube cuff inflation‐deflation method: Tracheal tube cuff is inflated with a variable amount of air (volume of air is depending on the level of the larynx). Once the tip of endotracheal tube at the laryngeal inlet, the cuff of the endotracheal tube is deflated and advanced into the trachea Patients included in the study will be assigned into two groups for the second phase of airway management: Group A (n = 45) in whom nasal intubation will be performed using the cuff inflation‐deflation method; and Group B (n = 45), in whom the nasal intubation will be performed using non‐inflation method.