To prospectively investigate the risk factors that associate to ala nasi pressure sores after general anesthesia with nasotracheal intubation. Material and method: All Patients underwent oral and maxillofacial surgeries during May 2018 to December 2018 were enrolled in this prospective study. Alae nasi were evaluated after finishing of the operation under general anesthesia with nasotracheal intubation for having pressure sore or not. The seven suspected risk factors were investigated for evaluation of the significant association with ala nasi pressure sores. Descriptive, univariate, and multivariate statistics were computed, and the P value was set at .05. Results: One hundred and fifty-five patients were enrolled. The incident of ala nasi pressure sore after general anesthesia with nasotracheal intubation was 21.45% in duration of six months. Risk factors associated with ala nasi pressure sore with univariate analysis were long duration of surgery, and lack of hydrocolloid dressing. After multivariate analysis, the significant risk factors for ala nasi pressure sores after general anesthesia with nasotracheal intubation were long duration of surgery (OR 1.005, 95%CI 1.002 to 1.009, p ¼ 0.004), and lack of hydrocolloid dressing (OR 9.934, 95%CI 3.347 to 29.489, p < 0.001). While the significant protective factor was higher body mass index (OR 0.864, 95% CI 0.749 to 0.997, p ¼ 0.045). Conclusion: Long duration of surgery and lack of hydrocolloid dressing are significant risk factors for ala nasi pressure sores after general anesthesia with nasotracheal intubation. While high body mass index is significant protective factor. Shortening the duration of surgery and using of hydrocolloid dressing between ala nasi and the nasotracheal tube or catheters that inserted via nose, such as nasogastric tube, are strongly recommended.

Sudden cardiac arrest (SCA) is an uncommon event in dental practice; however, the frequency of dentists encountering SCA and other major medical emergencies is increasing. We report the successful resuscitation of a patient who developed SCA while awaiting examination and treatment at a dental hospital. The emergency response team was called upon, and cardiopulmonary resuscitation/basic life support (CPR/BLS), including chest compression and mask ventilation, was promptly initiated. An automated external defibrillator was used, which indicated that the patient's cardiac rhythm was unsuitable for electrical defibrillation. The patient returned to spontaneous circulation after 3 cycles of CPR and intravenous epinephrine. The knowledge and skill levels of dentists regarding resuscitation under emergency circumstances should be addressed. Emergency response systems must be well established, and CPR/BLS knowledge and training should be updated regularly, including optimal management of both shockable and nonshockable rhythms.

Prior to a scheduled operation for a 45-year-old male patient with tongue cancer, a tracheotomy performed under intravenous sedation to prevent asphyxia due to extensive bleeding resulted in pneumomediastinum and subcutaneous emphysema. The planned operations were postponed until reduction of the pneumomediastinum was confirmed. During operation, airway pressure was kept low to prevent tension pneumomediastinum along with a sufficient depth of anesthesia, controlled analgesia, and continuous administration of muscle relaxants. Postoperatively, sedation was used to avoid stress and complications with the vascular anastomosis site. In this case, air leakage into the soft tissues was one of the possible causes of the event associated with increased airway pressure. Although the incidence of such complications is relatively low, caution should be exercised after tracheostomy.

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