Takasugi Yoshihiro, Futagawa Koichi, Umeda Takashi, Kazuhara Kouhei, Morishita Satoshi
Assistant Professor, Department of Anesthesiology, Kindai University Faculty of Medicine, Osaka, Japan.
Associate Professor, Department of Anesthesiology, Nara Hospital, Kindai University Faculty of Medicine, Nara, Japan.
Anesth Prog. 2018 Summer;65(2):100-105. doi: 10.2344/anpr-65-02-06.
Thermosoftening treatment of polyvinyl chloride (PVC) nasotracheal tubes (NTTs) can reduce the incidence and amount of epistaxis during nasotracheal intubation. The optimal thermal setting for thermosoftening treatment of NTTs without burn injury was investigated. Two composite types of PVC NTTs were used. Following withdrawal of the PVC NTTs from a bottle of water at 45 or 60°C, the changes in the surface temperature of the NTTs were measured by infrared thermography. Hardness of the NTTs at 25, 30, 35, and 40°C was measured. The incidence of epistaxis during nasotracheal intubation using thermosoftened NTTs was evaluated retrospectively. The surface temperature of both PVC NTTs dipped in 45 and 60°C water decreased to below body temperature 30 seconds after withdrawing them from the bottles. Although thermosoftening treatment proportionally decreased the hardness of both types of NTTs, the degrees differed according to their composition. When avoiding impingement of the NTT on the posterior wall of the nasopharynx, the incidence of mild and moderate epistaxis was 2.3%. Flexibility of PVC NTTs could be obtained by thermosoftening treatment at 60°C without burn injury. Thermosoftening treatment of PVC NTTs may be useful to avoid epistaxis during nasotracheal intubation.
聚氯乙烯（PVC）鼻气管导管（NTT）的热软化处理可降低鼻气管插管期间鼻出血的发生率和出血量。研究了NTT热软化处理且无烧伤的最佳热设置。使用了两种复合类型的PVC NTT。将PVC NTT从45或60°C的水瓶中取出后，通过红外热成像测量NTT表面温度的变化。测量NTT在25、30、35和40°C时的硬度。回顾性评估使用热软化NTT进行鼻气管插管期间鼻出血的发生率。两种浸入45和60°C水中的PVC NTT从瓶中取出30秒后，其表面温度均降至体温以下。尽管热软化处理按比例降低了两种类型NTT的硬度，但程度因它们的成分而异。当避免NTT撞击鼻咽后壁时，轻度和中度鼻出血的发生率为2.3%。通过在60°C进行热软化处理可获得PVC NTT的柔韧性且无烧伤。PVC NTT的热软化处理可能有助于避免鼻气管插管期间的鼻出血。
