Episodic nocturnal hypoxia and nasal packs

Abstract

Nasal obstruction influences respiration during sleep and nasal packs may cause obstructive sleep apnoea. In order to investigate this, the perioperative oxygen saturation was monitored for 3 nights with continuous pulse oximetry in 12 patients, who had bilateral nasal packs after septoplasty. A significant increase in the number of nocturnal episodes of hypoxia and a significant prolongation of the mean duration of the individual hypoxic periods were demonstrated during the first and the second post-operative nights. The clinical significance of these results is as yet unknown, but the use of partial nasal packing in septoplasty is advocated. Further investigations of nocturnal oxygen desaturation and design of nasal packs, securing the post-operative nasal airway, are needed.

Use of nasal packs and intranasal septal splints following septoplasty

“…This was observed by JENSEN et al 6 in the form of nocturnal hypoxia during the first and the second nights after the operation.…”

“…Intranasal packing pro- duces some quality-of-life problems for patients. These include problems with nasal respiratory function that can cause degrees of hypoxia 6,16 , mouth dryness and sore throat. Serious infections, aspiration and cardiologic complications may also occur.…”

Front-line epistaxis management: let's not forget the basics

“…Some doctors may advocate discharging patients with nasal packing in situ; however, in one unit which did so, there was a readmission rate of 16 per cent due to rebleeding 11 . Furthermore, several complications of nasal packing, such as swallowed packs, 5 nocturnal hypoxia 6 and toxic shock syndrome, 7 could have serious consequences if occurring at home.…”

Effect of Total Nasal Obstruction on Nocturnal Oxygen Saturation

“…However, a review of the literature on nocturnal oximetry in patients with nasal packing reveal conflicting results-ranging from significant reductions in arterial oxygen saturation to the absence of changes. [10][11][12][13] This study explores the repercussion of nasal obstruction on arterial oxygen saturation during the nocturnal resting hours and its implication in SDB, particularly OSAS. To this effect, nocturnal oximetric studies were made in patients with total nasal obstruction, with and without packing, to determine whether nasal obstruction effectively causes a significant decrease in arterial oxygen saturation.…”