Razavi Majid, Taghavi Gilani Mehryar, Bameshki Ali Reza, Behdani Reza, Khadivi Ehsan, Bakhshaee Mahdi
Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
General Practitioner, Young Researchers Club and elites, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
Iran J Otorhinolaryngol. 2015 Nov;27(83):423-8.
Controversy remains as to the advantages and disadvantages of pharyngeal packing during septorhinoplasty. Our study investigated the effect of pharyngeal packing on postoperative nausea and vomiting and sore throat following this type of surgery or septorhinoplasty.
This clinical trial was performed on 90 American Society of Anesthesiologists (ASA) I or II patients who were candidates for septorhinoplasty. They were randomly divided into two groups. Patients in the study group had received pharyngeal packing while those in the control group had not. The incidence of nausea and vomiting and sore throat based on the visual analog scale (VAS) was evaluated postoperatively in the recovery room as well as at 2, 6 and 24 hours.
The incidence of postoperative nausea and vomiting (PONV) was 12.3%, with no significant difference between the study and control groups. Sore throat was reported in 50.5% of cases overall (56.8% on pack group and 44.4% on control). Although the severity of pain was higher in the study group at all times, the incidence in the two groups did not differ significantly.
The use of pharyngeal packing has no effect in reducing the incidence of nausea and vomiting and sore throat after surgery. Given that induced hypotension is used as the routine method of anesthesia in septorhinoplasty surgery, with a low incidence of hemorrhage and a high risk of unintended retention of pharyngeal packing, its routine use is not recommended for this procedure.
鼻中隔成形术中咽腔填塞的利弊仍存在争议。我们的研究调查了咽腔填塞对这类手术或鼻中隔成形术后恶心呕吐和咽痛的影响。
本临床试验对90例美国麻醉医师协会（ASA）分级为I或II级、拟行鼻中隔成形术的患者进行。他们被随机分为两组。研究组患者接受了咽腔填塞，而对照组患者未接受。术后在恢复室以及术后2小时、6小时和24小时，根据视觉模拟评分法（VAS）评估恶心呕吐和咽痛的发生率。
术后恶心呕吐（PONV）的发生率为12.3%，研究组和对照组之间无显著差异。总体上，50.5%的病例报告有咽痛（填塞组为56.8%，对照组为44.4%）。尽管研究组在所有时间点的疼痛程度都更高，但两组的发生率无显著差异。
咽腔填塞对降低术后恶心呕吐和咽痛的发生率没有效果。鉴于诱导低血压是鼻中隔成形术的常规麻醉方法，出血发生率低且咽腔填塞意外残留风险高，不建议在该手术中常规使用咽腔填塞。
