Muluk Nuray Bayar, Apan Alpaslan, Ozçakir Sibel, Arikan Osman Kürşat, Koç Can
ENT Department, School of Medicine, Kirikkale University, Turkey.
Auris Nasus Larynx. 2008 Dec;35(4):521-6. doi: 10.1016/j.anl.2007.12.007. Epub 2008 Mar 7.
This prospective study investigated the risk of respiratory distress in the patients who were applied nasal packing at the end of nasal surgery; and effects of nasal packing on consciousness level while the patients were awake or asleep, measured by Bispectral Index (BIS).
The study group consisted of 15 adult patients (10 male, 5 female), who were applied nasal packing at the end of nasal surgery. The control group consisted of 15 adult patients (10 male, 5 female), who received general anesthesia for various reasons. In the study and control groups, BIS index, respiratory rate, peripheral oxygen saturation, pulse per minute and blood pressure were measured at seven different times.
There was no statistically significant difference between BIS indexes of the study and control groups. In the fourth hour after sleep (AS-4h), respiratory rate of the study group was significantly lower than that of the control group. In the fourth hour after the anesthesia (AA-4h), oxygen saturation value of the study group was lower than that of the control group.
We conclude that in patients who are applied nasal packing at the end of nasal surgery; at AA-4h and AS-4h times, there may be risk of decrease in the oxygen saturation and respiratory rate parameters, respectively. Therefore, it is necessary to monitor non-invasive respiratory parameters and to give enriched oxygen by an oral catheter.
本前瞻性研究调查了在鼻手术结束时进行鼻腔填塞的患者发生呼吸窘迫的风险；以及通过脑电双频指数（BIS）测量鼻腔填塞对患者清醒或睡眠时意识水平的影响。
研究组由15例成年患者（10例男性，5例女性）组成，这些患者在鼻手术结束时进行了鼻腔填塞。对照组由15例成年患者（10例男性，5例女性）组成，他们因各种原因接受全身麻醉。在研究组和对照组中，在七个不同时间测量BIS指数、呼吸频率、外周血氧饱和度、每分钟脉搏和血压。
研究组和对照组的BIS指数之间无统计学显著差异。在睡眠后第4小时（AS - 4h），研究组的呼吸频率显著低于对照组。在麻醉后第4小时（AA - 4h），研究组的血氧饱和度值低于对照组。
我们得出结论，在鼻手术结束时进行鼻腔填塞的患者中；在AA - 4h和AS - 4h时，可能分别存在血氧饱和度和呼吸频率参数下降的风险。因此，有必要监测无创呼吸参数并通过口导管给予富氧。
