Comparing the Efficacy of Fentanyl Nasal Packing on Postoperative Pain in Patients Undergoing Nasal Surgeries Versus Normal Saline Pack-A Randomized Control Trial.

Nasal packing following nasal procedures are commonly used to reduce post operative bleeding and pain. Removal of nasal pack may be associated with mucosal injury which may cause delayed recovery. Various aspects of post-operative pain management have been studied. Opioids such as fentanyl, morphine and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat postoperative pain. Fentanyl used topically results in a longer duration of action with a lower dosage and fewer adverse effects than IV therapy. To compare the efficacy of Fentanyl-soaked Nasal Packing on post operative pain in patients undergoing Nasal surgeries versus normal saline pack. A randomized control trial conducted among patients undergoing Nasal Surgery in the age group between 20 to 50 years at a tertiary care centre, Puducherry, India. Patients were randomly divided into two groups with 34 participants in each. Group A received Postoperative Nasal pack with 50mcg of Fentanyl and group B received Postoperative Nasal pack with Normal saline. Data were analysed using SPSS 21. The mean RSS score was 2.03 ± 0.83 and 1.38 ± 0.49 in group A and B respectively. The RSS score was significantly higher among group A than B. At all hours, mean Verbal pain intensity scale and numeric pain rating scale were significantly lower among Group A than B. At 1, 6,12 and 36 hours, Wong-Baker pain rating scale was significantly lower among Group A than B. There was no significant difference in hemodynamic parameters between the groups. The fentanyl group experienced much less postoperative pain without experiencing any significant adverse effects. We propose that applying topical fentanyl to nasal packs may be a feasible strategy to alleviate discomfort during the initial phases of recovery following nasal surgery.