Effect of pharyngeal packing during nasal surgery on postoperative nausea and vomiting

Korkut, Arzu Yasemin; Kerem, Eitan; Erden, Veysel; Teker, Ayşenur Meriç; Demirel, Asiye; Gedikli, Orhan; Saidoglu, Leyla

doi:10.1016/j.otohns.2010.08.030

Cited by 46 publications

(60 citation statements)

References 24 publications

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“…It suggested that further studies be done to confirm best practice techniques . Since that time, two prospective, randomized, controlled, double‐blinded studies have been published in the literature . Both studies concluded that pharyngeal packs have no effect on pain or PONV.…”

Section: Introductioncontrasting

confidence: 98%

“…However, the authors concluded that postoperative pain was higher in the pharyngeal pack group. This was in contrast to the findings of Korkut et al and Fennessey et al that there was no difference in pain between the groups. A major weakness to the Iranian study is that the authors included a variety of otolaryngologic surgeries and not just FESS.…”

Section: Introductioncontrasting

confidence: 98%

“…The main premise for the use of pharyngeal packs in sinus surgery theoretically is to prevent ingestion of blood products to reduce postoperative nausea and vomiting. Our study found that the placement of a pharyngeal pack did not reduce PONV, as has been found in the literature . Our findings suggest that there is no need to place a pharyngeal pack to prevent nausea/vomiting in patients undergoing endoscopic sinus surgery.…”

Section: Discussionmentioning

confidence: 99%

“…By decreasing the ingestion of blood products, it is presumed that pharyngeal packs can decrease the incidence of postoperative nausea and vomiting (PONV). However, studies have failed to adequately demonstrate that pharyngeal packs decrease postoperative nausea and vomiting …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial

et al. 2017

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Section: Introductioncontrasting

confidence: 98%

Section: Introductioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial

et al. 2017

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“…[34] Apart from the common surgical complication such as bleeding, orbital trauma, intracranial injury and infection, various other complications like aspiration, embolism, nausea and vomiting, myocardial infarction, airway edema and obstruction can also arise. [567891011] The obstructive component can be severe at times leading to re-intubation for maintaining patency of airway. Normally the mechanism of breathing is a very complex phenomenon which is hardly perceived during the routine daily chores.…”

Section: Introductionmentioning

confidence: 99%

Postoperative airway management after nasal endoscopic sinus surgery: A comparison of traditional nasal packing with nasal airway

et al. 2013

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Background:Nasal packing after the nasal surgery can be extremely hazardous and can lead to airway complications such as dyspnea and respiratory obstruction.Objective:The present study aimed at comparing the traditional nasal packing with nasal airway during the immediate postoperative period in patients undergoing fibreoptic endoscopic sinus surgery (FESS) under general anaesthesia (GA) with regards to airway management.Materials and Methods:The study groups consisted of 90 ASA grade I and II patients aged 16 to 58 years who underwent FESS under GA. Patients were randomly assigned into three groups: Group NP, UA and Group BA of 30 patients each. At the end of surgery, Group NP patients were managed with traditional bilateral nasal packing while a presterilized 5 mm ID uncuffed ETT was cut to an appropriate size and inserted into one of the nostrils in UA and bilaterally in BA group patients. During postoperative period following parameters and variables were observed over the next 24 hours: Any respiratory distress or obstruction, pain and discomfort, oxygen saturation, heart rate, blood pressure, bleeding episode, ease of suctioning through nasal airway, anaesthesiologists and surgeons satisfaction during postoperative period, discomfort during removal of nasal airway and any fresh bleeding episode during removal of nasal airway. The data was compiled and analyzed using Chi-square test and ANOVA with post-hoc significance. Value of P < 0.05 was considered significant and P < 0.0001 as highly significant.Results:The post-op mean cardio-respiratory parameters showed significant variations among NP group (P < 0.05) and the patient of UA and BA groups while intergroup comparison between UA and BA was non-significant (P > 0.05). Pain and discomfort, bleeding episode, ease of suctioning through nasal airway, pain and bleeding during removal of nasal airway (P < 0.0001) as well as surgeons and anaesthesiologists satisfaction criteria showed significant results among the NP group as compared to UA and BA groups (P < 0.05).Conclusion:The present intervention to maintain airway patency can be termed as excellent with additional benefits like ease of suctioning; oxygen supplementation and a possible haemostatic effect due to pressure on the operated site. The low cost of the modified nasal airway and easily replicable design were the standout observations of the present study.

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Perioperative local anaesthesia for reducing pain following septal surgery

Fujiwara

Kuriyama

Kato

et al. 2018

Cochrane Database of Systematic Reviews

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The addition of local anaesthesia to nasal packs (if these are being used) following septal surgery may reduce postoperative pain within the first 12 hours, compared to nasal packing with a placebo added. The effect is uncertain at 24 hours because the quality of the evidence is very low. Evidence was lacking for other outcomes, including adverse effects. There is a lack of evidence about the effects of local anaesthesia added to nasal packing compared to no nasal packing. There is also a lack of evidence about the effects of local anaesthesia given by injection and the effects of sphenopalatine ganglion block.

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Effect of pharyngeal packing during nasal surgery on postoperative nausea and vomiting

Abstract: Pharyngeal packing in nasal surgery has no impact on PONV.

Cited by 46 publications

References 24 publications

Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial

Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial

Postoperative airway management after nasal endoscopic sinus surgery: A comparison of traditional nasal packing with nasal airway

Perioperative local anaesthesia for reducing pain following septal surgery

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