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 56
- Downloads 0
The Serological Evidence of Cytomegalovirus Infection as a Potent Aetiological Factor for Cleft Lip/Palate, Mental Retardation and Deafness
Introduction: Congenital Cytomegalovirus (CCMV) infection is estimated to occur in 0.5% to 2% of all deliveries across the world. According to the available literature about Human Cytomegalovirus (HCMV) infected children...
Assessment of Insulin Sensitivity and its Convalescence with Dietary Rehabilitation in Undernourished Rural West Bengal Population
Introduction: Metabolic syndrome involving diabetes is acquiring the eminence of prospective epidemic in India with dramatic rise in rural population prevalence where majority are undernourished and creates significant h...
A Study on Chronic Proton Pump Inhibitor Usage and Small Intestinal Bacterial Overgrowth (SIBO)
ABSTRACT Introduction: Small Intestinal Bacterial Overgrowth (SIBO) has a wide clinical spectrum, and may be associated with both maldigestion and malabsorption. Proton Pump Inhibitors (PPI) are one of the most widely pr...
Study on Hair Fall with Hair Related Problems among Males of Age 18-50 Years: Study on Chennai Based Population
ABSTRACT Introduction: Male pattern hair loss is often regarded as a relatively minor medical condition; however, may result in anxiety and depression in some men as it impacts self-image. Hair loss is a common cosmetic...
Catheter-Assisted Balloon-Supported Retrieval of a Broken Semi-Compliant Balloon from a Coronary Artery
Incidents of broken balloon in a coronary vasculature during percutaneous coronary angioplasty are very rare. Such events in cath-lab may create panic and can be life threatening for patients. Hence, immediate retrieval...