Effect of 2% Nasal Mupirocin Ointment on Decreasing Complications of Nasotracheal Intubation: A Randomized Controlled Trial
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 8
Abstract
Introduction: In oral and maxillofacial surgeries, nasotracheal intubation is carried out to increase the surgeon’s access to the oral cavity. During nasotracheal intubation the risk of trauma is higher than that in orotracheal intubation as there is passage of the tube through the mucosa of the nasal tract due to which bacteria might get transported into the trachea. Aim: To evaluate the effect of 2% nasal mupirocin ointment before and after nasotracheal intubation on decreasing the complications of intubation for oral and maxillofacial surgeries. Materials and Methods: In the present single blinded randomised controlled clinical trial, 44 patients were randomly assigned to two equal groups. A sterile swab was used, eight to 10 hours before nasotracheal intubation, to take a sample for culturing from the vestibule of nostrils and the anterior septum of the patients. In Group 1, 2% nasal mupirocin ointment was applied to the vestibules of both nostrils and the anterior septum. In Group 2, no intervention was carried out. After general anaesthesia and extubation, microbial cultures were prepared from the 4 cm distal end of the tube and antibiogram test was carried out. Also, the patients were compared in terms of the severity of nasal bleeding, the ease of breathing through the nose after nasotracheal intubation. Data were analysed with suitable statistical tests. Results: In the mupirocin group, 27.2% of the subjects were carriers of Staphylococcus aureus in the nasal cavity but no S. aureus was detected at the distal end of nasotracheal tube after extubation. In the control group, 18.2% of the subjects were carriers of Staphylococcus aureus in the nasal cavity but there was no change in the number of S. aureus counts at the distal end of nasotracheal tube (p-value<0.001). After extubation, in the mupirocin and control groups, 18.2% and 22.7% of the subjects, respectively, exhibited severe bleeding (p-value=0.001). In the mupirocin and control groups, 86.4% and 59.1% of the subjects had easy extubation, respectively (p-value=0.044). In the mupirocin and control groups, 9.1% and 63.7% of the subjects immediately after regaining consciousness and 9.1% and 54.6% three hours after extubation had difficulty in breathing, respectively (p-value=0.001). Conclusion: Use of mupirocin before nasotracheal intubation decreased the complications of nasal intubation in addition to decreasing the risk of colonization of S. aureus and other gramnegative bacteria.
Authors and Affiliations
Kourosh Taheri Talesh, Reza Movassaghi Gargary, Seyed Ahmad Arta, Javad Yazdani, Monireh Roshandel, Milad Ghanizadeh, Hossein Samadi Kafil, Mir Naser Seyyed Mousavi
Keywords
Related Articles
- EP ID EP359030
- DOI 10.7860/JCDR/2017/29575.10396
- Views 66
- Downloads 0
Massive Squamous Cell Carcinoma of the Orbit: A Rare Case Report
Squamous Cell Carcinoma (SCC) is the second most common eyelid malignancy worldwide. SCC is an aggressive tumour, with the ability to cause significant morbidity, mortality and the risk of rapid spread. Hence, urgent dia...
Formulation and Evaluation of Sol-Gel Drug Delivery System for Intracanal pH Sensitive Controlled Delivery of Chlorhexidine
Introduction: Persistence of viable micro-organisms even after thorough chemomechanical debridement has been cited as a major cause for endodontic failure. Chlorhexidine is a drug, which has shown marked efficacy against...
A Rare Case of Osteopetrosis with Unusual Feature as Microcephaly
Images in Medicine
Influence of Tobacco Chewing and Smoking on the Salivary Total Antioxidant Power-A Clinical Comparative Study
ABSTRACT Introduction: Both smoking and tobacco chewing are associated with increased risk of oral cancer due to the imbalance in the free radicals and antioxidants. Saliva is the first biological medium encountered duri...
Sinonasal Schwannoma – A Case Report
Schwannomas are benign peripheral nerve sheath tumours that may occur throughout the body. They rarely occur in the nasal cavity. Paranasal schawannomas are uncommon lesions, representing less than 4% of all head and nec...