Does Type of Pharyngeal Packing during Sinonasal Surgery Have an Effect on PONV and Throat Pain?

Otolaryngol Head Neck Surg. 2016 Apr;154(4):742-7. doi: 10.1177/0194599815626126. Epub 2016 Jan 19.

Abstract

Objective: Postoperative nausea and vomiting (PONV) is a common problem that affects up to 30% of all surgical patients after general anaesthesia, which increases in sinonasal surgery due the very potent emetic effect of ingested blood that is swallowed during the procedures. Therefore, a hypo/oropharyngeal packing is commonly placed in an effort to prevent blood ingestion. The primary aim of this study was to compare the efficacy of 3 packing types in preventing PONV and to compare the results with patients who received no packing. The secondary aim was to compare the postoperative throat pain in all 4 groups.

Study design: A prospective double-blind randomized controlled study.

Setting: A university hospital.

Subjects and methods: After Institutional Review Board approval and informed consent, 201 adult patients scheduled for sinonasal surgery were randomized to 4 groups to have dry packing (n = 52), packing soaked with water (n = 48), packing soaked with chlorhexidine gluconate and benzydamine hydrochloride (n = 51), or no packing (n = 50). Postoperative PONV and throat pain were assessed.

Results: Demographic data, procedural characteristics, and PONV risk scores were similar among groups. The PONV incidences, throat pain scores, and analgesic use were comparable in all 4 groups.

Conclusion: Despite commonly used practices, usage of different types of pharyngeal packing did not affect incidence of PONV and throat pain, nor did usage of no packing.

Keywords: pharyngeal packing; postoperative nausea and vomiting; sinonasal surgery; throat pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesia, General / adverse effects
  • Double-Blind Method
  • Female
  • Hospitals, University
  • Humans
  • Incidence
  • Intraoperative Care
  • Intubation, Intratracheal / adverse effects
  • Male
  • Pain, Postoperative / prevention & control*
  • Paranasal Sinus Diseases / surgery*
  • Pharyngitis / epidemiology
  • Pharyngitis / etiology
  • Pharyngitis / prevention & control*
  • Postoperative Nausea and Vomiting / epidemiology
  • Postoperative Nausea and Vomiting / etiology
  • Postoperative Nausea and Vomiting / prevention & control*
  • Prospective Studies
  • Tampons, Surgical*