Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
Department of Surgery, Division of Plastic Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
Aesthet Surg J. 2022 Jun 20;42(7):743-748. doi: 10.1093/asj/sjab410.
Advances in surgical and anesthetic techniques have led to a growing interest in performing procedures at ambulatory surgery centers. However, procedures involving the oropharyngeal or nasopharyngeal region may lead to the ingestion of blood, which can lead to postoperative nausea and vomiting (PONV). To date, limited studies have largely failed to demonstrate the benefits of oropharyngeal throat packing.
The authors aimed to investigate whether throat packing during elective septorhinoplasty increases the incidence of postoperative throat pain and assess its effects on PONV.
A randomized, prospective, single-blinded study was performed on 101 patients undergoing elective septorhinoplasty who received oropharyngeal throat packing vs no packing to compare the incidence of PONV and throat pain in the immediate postoperative period in addition to postoperative day (POD) 1 and 2.
The incidence and severity of postoperative throat pain were significantly greater in patients receiving throat packs in the immediate postoperative period and on POD 1. Significant differences in throat pain and incidence between the 2 groups diminished by POD 2. Patients having received throat packs also demonstrated a higher utilization of opioids in postanesthesia care unit. The incidence of PONV did not significantly differ between the 2 cohorts at any point of observations.
The results of this study largely agree with previous data that throat packs may contribute to postoperative throat pain while not significantly altering the incidence of PONV. Considering these data, we do not recommend routine utilization of throat packing during elective septorhinoplasty.
手术和麻醉技术的进步使得在日间手术中心进行手术的兴趣日益增加。然而,涉及口咽或鼻咽区域的手术可能会导致血液摄入,从而导致术后恶心和呕吐(PONV)。迄今为止,有限的研究在很大程度上未能证明咽部填塞的益处。
作者旨在研究择期鼻中隔成形术中进行咽部填塞是否会增加术后咽喉疼痛的发生率,并评估其对 PONV 的影响。
对 101 例行择期鼻中隔成形术的患者进行了一项随机、前瞻性、单盲研究,比较了接受或不接受咽部填塞的患者的 PONV 和术后即刻、第 1 天和第 2 天的咽喉疼痛发生率。
接受咽部填塞的患者在术后即刻和第 1 天的咽喉疼痛发生率和严重程度明显更高。第 2 天两组间的咽喉疼痛和发生率的差异显著减小。接受咽部填塞的患者在麻醉后护理单元中也使用了更多的阿片类药物。两组患者在任何观察点的 PONV 发生率均无显著差异。
本研究结果与先前的数据基本一致,即咽部填塞可能会导致术后咽喉疼痛,但不会显著改变 PONV 的发生率。考虑到这些数据,我们不建议在择期鼻中隔成形术中常规使用咽部填塞。