Pain Clinical Trial
Official title:
A Comparison Between Conventional Throat Packs and Pharyngeal Placement of Tampons in Rhinology Surgeries
Post-operative, throat pain, nausea and vomiting is a common occurrence in rhinology surgeries due to the use of throat packs during the procedure. In order to optimize quality of care and patient satisfaction, the aim of this study to evaluate the incidence of post-operative, throat pain, nausea and vomiting in patients that have been packed with either conventional gauze throat packs or pharyngeal tampons.
The nose and para nasal sinuses are anatomically known to be highly vascular and a
substantial amount of bleeding is expected from rhinology surgeries, ingested blood is known
to be a power full emetic, and the risk aspiration of blood is present due to the fact that
an endotracheal tube is not 100% effective in protecting the airway. Post-operative nausea
and vomiting is a frequent problem that is encountered in surgical patients with a 4th to 6th
fold increase in nasal and endoscopic sinus operations.
Posterior throat pack is an often-used in rhinology surgery, it is said to help in protecting
the air way against aspiration and also helps in the reduction of post-operative nausea and
vomiting, however many studies concluded that posterior throat pack is associated with higher
amount of post-operative pain, nausea,, vomiting and in some rare cases even forgotten in the
patient leading to mortality. However, despite poor evidence the placement of posterior
throat packs is commonly practiced by surgeons and anesthetists because the possible risk of
aspiration is worrisome to the latter and the former.
A conventional throat pack consists of gauze, but an alternative practice involves the
pharyngeal placement of tampons. In Marais and Prescott posterior pharyngeal placement of
tampons is associated with a decrease amount of post-operative throat pain, when compared to
conventional gauze throat packs, however they did not compare the incidence of post-operative
nausea and vomiting in both groups.
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