1/13/2024 0 Comments 3m micro foam tapeThreshold response was calculated based on the statistical results of a pilot study where the patient distribution in the amount of nasal pressure injury of the nasal tip to the nasal alar after extubation was used as a standard (group S, n = 10 group C, n = 10). We estimated that a minimum sample of 56 patients would be needed, where the threshold response, αerror, and power (1− β) were set at 40%, 0.05%, and 0.80% respectively. The nasotracheal tube used in this study was Polar™ Preformed Tracheal Tube (Smith Medical Japan Ltd, Tokyo), and the tube size was ID 7.0 mm for men and ID 6.5 mm for women. In group C, the nasotracheal tube was fixed in place after NTI without protection. The vertical 1/3 of 3ST was bent toward the nasal cavity using dental tweezers (Fig. Subsequently after NTI and before securing the nasotracheal tube, group S used a 35-mm wide and 35-mm long 3ST to protect the nasal wing. Following this, NTI through the right nostril was performed to reduce the risk of nasal bleeding. Tramazoline was used for hemostasis during NTI. ![]() ![]() Subsequently, mask ventilation was applied at 100% oxygen with propofol and remifentanil, and the patients’ nasal mucosa and inferior nasal passages were adequately disinfected using benzalkonium (ZALKONIN ® SOLUTION 0.025, Kenei Pharmaceutical Co., Ltd, Osaka). Anesthesia was induced using propofol (3 μg/mL target control infusion), remifentanil (0.2 µg/kg/minutes), and fentanyl (100 µg) with rocuronium (0.6 mg/kg) used as a neuromuscular blocking agent. The standard vital signs monitors (electrocardiogram, blood pressure, and oxygen saturation) were inspected. The same method of anesthesia was employed for all patients. Therefore, we hypothesized that 3ST prevents nasal pressure injury associated with NTI and decided to investigate this hypothesis. Additionally, it has the advantage of being relatively inexpensive compared to hydrocolloid products, and to our knowledge, there are no prospective randomized trials in the literature on the use of 3ST for preventing nasal pressure injury associated with NTI. 3M microfoam™ surgical tape (3ST: 3M Japan Limited) is used for pressure wound control of medical equipment moreover, it is cushioned and can be fitted to any part of the body. Surgical tape can be considered an alternative to hydrocolloid dressing. Therefore, there is still a need to establish new strategies for preventing nasal pressure injury associated with NTI. Hoshijima et al state that the meta-analysis of nasal protection strategy suggests that the use of a nasal protection strategy considerably reduces the risk of a nasal pressure injury during NTI however, the number of samples in the meta-analysis was too small for trial sequential analysis, thus further research is needed. However, hydrocolloid dressing is relatively expensive and difficult to use owing to its product form. It is reported that the application of hydrocolloid dressing to the nasal alar is effective in preventing nasal pressure injury associated with NTI. According to several reports, nasotracheal tubes are closely associated with medical device-related pressure injuries. They revised the definition and changed the term “pressure ulcers” to “pressure injuries” in 2016 and included medical device-related pressure injuries and mucosal membrane pressure injuries in the category. ![]() The National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan-Pacific Pressure Injury Alliance collectively published The Prevention and Treatment of Pressure Ulcers. Furthermore, nasal pressure injury, including pressure ulcers or necrosis, during NTI occurs in 10% to 50% of cases and can lead to many postoperative issues such as persistent pain, cosmetic issues, and persistent treatment. However, some complications associated with NTI such as nasal bleeding, bacteremia, retropharyngeal perforation, and pressure ulcers or necrosis of nasal alar have been reported. Nasotracheal intubation (NTI) is frequently necessary during dental and oral maxillofacial surgeries, specifically during operations with operative field and airway converge.
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