Bresnihan M, Mehigan B, Curran A
Department of ENT, St Vincents University Hospital, Elm Park, Dublin 4, Ireland.
Clin Otolaryngol. 2007 Oct;32(5):352-5. doi: 10.1111/j.1749-4486.2007.01517.x.
The primary objective of this study was to compare postoperative pain levels between Merocel and Series 5000 nasal packs.
A prospective randomised, single blind, paired control trial.
A single consultant in two tertiary Otolaryngology units.
Twenty-four adults, ASA 1, who underwent septoplasty, endoscopic sinus surgery or both, were considered after exclusion criteria were applied: bleeding abnormalities, patients taking anticoagulant medications and any significant co-morbidity requiring admission beyond 24-h postoperatively. Twenty-one patients were randomly assigned to have one side of their nose packed with Merocel pack and the other with Series 5000 overnight.
The difference in pain levels, using a visual analogue scale, both with the pack in situ and on removal.
In 20 patients, the mean pain scores while the packs were in situ were 3.78 for Merocel and 3.62 for Series 5000 and was not found to be significantly different (P = 0.65. 95% CI = -0.57-0.89). The mean pain score on removal of the Merocel pack was five and for the Series 5000 was 3.08. The Series 5000 pack was significantly less painful than Merocel on removal (P < 0.0001. 95% CI = 1.11-2.7). Both were equally effective in their stability and haemostatic effect.
Both the Merocel and Series 5000 packs are effective packs regarding haemostasis and have equivalent pain levels while in situ. However, the Series 5000 pack was significantly less painful on removal of the pack.
本研究的主要目的是比较美罗海绵(Merocel)和5000系列鼻腔填塞物术后的疼痛程度。
一项前瞻性随机、单盲、配对对照试验。
两个三级耳鼻喉科单位的一名顾问医生处。
24名美国麻醉医师协会(ASA)分级为1级的成年人,他们接受了鼻中隔成形术、鼻内镜鼻窦手术或两者皆有,在应用排除标准后进行研究:出血异常、服用抗凝药物的患者以及任何需要术后24小时以上住院治疗的严重合并症。21名患者被随机分配,一侧鼻腔用美罗海绵填塞,另一侧用5000系列填塞过夜。
使用视觉模拟量表,比较填塞物在位时和取出时的疼痛程度差异。
20名患者中,填塞物在位时,美罗海绵的平均疼痛评分为3.78,5000系列为3.62,未发现显著差异(P = 0.65,95%可信区间 = -0.57 - 0.89)。取出美罗海绵填塞物时的平均疼痛评分为5分,5000系列为3.08分。取出时,5000系列填塞物的疼痛明显低于美罗海绵(P < 0.0001,95%可信区间 = 1.11 - 2.7)。两者在稳定性和止血效果方面同样有效。
美罗海绵和5000系列填塞物在止血方面均有效,在位时疼痛程度相当。然而,取出5000系列填塞物时疼痛明显较轻。