Evidence map›Paper›PMID 39543472›Full record

Trial reportBMC anesthesiology2024

Microbiological comparison of the disinfecting efficacy of small and large cotton swabs in nasotracheal intubation: a randomized trial.

Makoto Hirohata, Naoko Tachi, Yuji Kamimura, Yoshiki Sento, Eisuke Kako, Hiroshi Hoshijima, Masahiro Okuda, Shota Tsukimoto, Kyoko Shida, Hidetaka Kuroda and 5 more

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Makoto HirohataDepartment of Microbiology, Aichi Gakuin University School of Dentistry, 1-100 Kusumotocho, Chikusa-ku, Nagoya, 464-8650, Japan.
Naoko TachiDepartment of Anesthesiology, Aichi Gakuin University School of Dentistry, 2-11 Suemori- dori, Chikusa-ku, Nagoya, 464-8651, Japan. bokuaiji@gmail.com.
Yuji KamimuraDepartment of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467- 8601, Japan.
Yoshiki SentoDepartment of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Eisuke KakoDepartment of Advanced Medical Nursing, Graduate School of Nursing, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Hiroshi HoshijimaDivision of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, 4- 1 Aoba, Sendai, 980-8575, Japan.
Masahiro OkudaDepartment of Anesthesiology, Aichi Gakuin University School of Dentistry, 2-11 Suemori- dori, Chikusa-ku, Nagoya, 464-8651, Japan.
Shota TsukimotoDepartment of Dental Anesthesiology, Kanagawa Dental University, 1-23 Ogawacho, Yokosuka-shi, 238-8570, Japan.
Kyoko ShidaDepartment of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467- 8601, Japan.
Hidetaka KurodaDepartment of Dental Anesthesiology, Kanagawa Dental University, 1-23 Ogawacho, Yokosuka-shi, 238-8570, Japan.
Takuro SanukiDepartment of Dental Anesthesiology, Kanagawa Dental University, 1-23 Ogawacho, Yokosuka-shi, 238-8570, Japan.
Yuka Kikuchi, Okayama Sedation Lab, 1-10 Nishifurumatu Nishimachi, Kita-ku, Okayama, 700-0926, Japan.
Kazuya SobueDepartment of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467- 8601, Japan.
Yoshiaki HasegawaDepartment of Microbiology, Aichi Gakuin University School of Dentistry, 1-100 Kusumotocho, Chikusa-ku, Nagoya, 464-8650, Japan.
Aiji Sato-BokuDepartment of Anesthesiology, Aichi Gakuin University School of Dentistry, 2-11 Suemori- dori, Chikusa-ku, Nagoya, 464-8651, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNasotracheal intubation (NTI) is necessary during surgeries requiring clear access to the surgical field and in patients with respiratory issues. This study investigates the pre-NTI nasal disinfection efficacy of different cotton swab sizes, hypothesizing that smaller swabs could minimize bleeding while maintaining disinfection efficacy.

methodsPatients classified as American Society of Anesthesiologists-physical status (ASA-PS) class 1 or 2 scheduled for general anesthesia with NTI were randomly assigned to either a large cotton swabs (LCS) or fine cotton swabs (FCS) group in this randomized controlled trial (RCT)." After anesthesia, a fine cotton swab was inserted into the inferior nasal meatus in both groups to collect bacteria (sample A). Next, the nasal cavity was disinfected with LCS or FCS according to the patient group. Bacteria were collected by inserting a fine cotton swab into the inferior nasal meatus (sample B). After surgery, bacteria were collected from the endotracheal tube tip using a fine cotton swab in both groups (sample C). The samples were cultured for 24 hours, and the colonies from samples A-C were counted. The changes in bacteria count between samples A and B and samples A and C were determined. Nasal bleeding from cotton swab insertion was assessed as a secondary outcome. Student's t-tests, a chi-square independence test, and Mann-Whitney U tests were used for the statistical analysis. The statistical significance level was set at p < 0.05.

resultsBetween samples A and B, the change in bacteria count was 7.2% (1.4-26.1%) (median[interquartile range]) in the LCS group and 6.9% (0.9-22%) in the FCS group (p = 0.90). Between samples A and C, the change in bacteria count was 7.5% (0.2-44%) in the LCS group and 8.3% (0.3-39%) in the FCS group (p = 0.55). We examined 62 subjects in each group (LCS and FCS), and samples A, B, and C were collected from all participants in both groups. Nasal bleeding occurred in 42/62 in the LCS group and 22/62 in the FCS group (p < 0.01).

conclusionCotton swab thickness did not impact disinfection efficacy, but large swabs increased the risk of nasal bleeding. We recommend FCS for nasal disinfection prior to NTI in ASA 1-2 patients, as they reduce bleeding risk without compromising disinfection.

trial registrationUMIN-CTR (registration no. UMIN000051495), June 30, 2023.

Indexed as

DisinfectionIntubation, IntratrachealAdultAnesthesia, GeneralCotton FiberEpistaxisFemaleHumansMaleMiddle AgedNasal CavityBenzalkonium chlorideCotton swabNasal bleedingNasotracheal intubation

Identifiers

PMID39543472
PMCPMC11562498

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.