Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Oral and Maxillofacial Surgery, School of Medicine, Emory University, Atlanta, Georgia, USA.
Int J Oral Maxillofac Surg. 2022 Mar;51(3):366-370. doi: 10.1016/j.ijom.2021.07.011. Epub 2021 Aug 6.
The oropharyngeal throat pack is commonly used in oral and maxillofacial surgery despite debated evidence regarding its barrier function. The study objectives were to investigate whether the oropharyngeal pack reduces blood ingestion and to evaluate its relationship with postoperative nausea and vomiting (PONV) and throat pain. This was a single-center, parallel group, single-blind randomized controlled trial. Participants undergoing orthognathic surgery, age ≥16 years, were included in the study. After intubation and prior to surgery start, the treatment group received oropharyngeal packing; the control group received no packing. Outcome variables were the quality of gastric contents aspirated by nasogastric tube (bloody or not bloody), PONV, and throat pain (visual analog scale). Thirty patients (treatment n = 15; control n = 15) were randomized and analyzed. There was no difference between the groups in quality of gastric contents (P = 1.00) or incidence of PONV at 2 hours and 24 hours (P = 1.00). Throat pain incidence and severity at 2 hours were both higher in the treatment group, but this was not statistically significant (P = 0.128, P = 0.223). The results indicate that the oropharyngeal pack is not an effective barrier against blood ingestion. Oropharyngeal packs do not improve or worsen PONV, but may increase throat pain.
口咽通气管包在口腔颌面外科中被广泛应用，尽管其屏障功能的证据存在争议。本研究的目的是调查口咽通气管包是否能减少血液摄入，并评估其与术后恶心呕吐（PONV）和咽喉疼痛的关系。这是一项单中心、平行组、单盲随机对照试验。研究纳入了接受正颌手术、年龄≥16 岁的患者。在插管后、手术开始前，治疗组接受口咽通气管包，对照组不进行包装。主要观察指标为经鼻胃管吸出的胃内容物质量（是否有血液）、PONV 和咽喉疼痛（视觉模拟评分）。30 名患者（治疗组 n = 15；对照组 n = 15）被随机分组并进行分析。两组患者胃内容物质量（P = 1.00）或术后 2 小时和 24 小时 PONV 发生率（P = 1.00）无差异。治疗组患者在术后 2 小时的咽喉疼痛发生率和严重程度均较高，但无统计学意义（P = 0.128，P = 0.223）。结果表明，口咽通气管包并不是防止血液摄入的有效屏障。口咽通气管包既不能改善也不能加重 PONV，但可能会增加咽喉疼痛。
