Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives

The objective of this study is to compare the nasal packing and the transseptal suturing techniques regarding the extubation difficulty evaluation scores, follow-up times in post-anaesthesia care unit (PACU), pain scores, and postoperative complications. Two hundred patients who underwent septoplast...

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Bibliographic Details
Published in:	European archives of oto-rhino-laryngology Vol. 268; no. 8; pp. 1151 - 1156
Main Authors:	Günaydın, Rıza Önder, Aygenc, Erdinc, Karakullukcu, Selma, Fidan, Fatih, Celikkanat, Serdar
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer-Verlag 01-08-2011 Springer
Subjects:	Adolescent Adult Anesthetics - pharmacology Biological and medical sciences Epistaxis - etiology Epistaxis - surgery Female Follow-Up Studies Head and Neck Surgery Hemostasis, Surgical - instrumentation Humans Male Medical sciences Medicine Medicine & Public Health Middle Aged Nasal Septum - surgery Neurosurgery Nose Deformities, Acquired - surgery Otorhinolaryngology Otorhinolaryngology. Stomatology Pain, Postoperative - drug therapy Pain, Postoperative - etiology Postoperative Hemorrhage - therapy Prospective Studies Rhinology Rhinoplasty - adverse effects Suture Techniques Tampons, Surgical Treatment Outcome Young Adult Nasal packing Transseptal suture Septoplasty PACU Extubation Treatment Surgery Nose ENT Technique Suture
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Summary:	The objective of this study is to compare the nasal packing and the transseptal suturing techniques regarding the extubation difficulty evaluation scores, follow-up times in post-anaesthesia care unit (PACU), pain scores, and postoperative complications. Two hundred patients who underwent septoplasty from January 2009 to October 2009 were randomly assigned either to have nasal packs ( n : 100) or transeptal sutures ( n : 100). In the transseptal suture group, extubation was easier and PACU follow-up times were shorter, when compared to the nasal packing group ( p < 0.001). Patients with nasal packing had significantly higher pain scores ( p < 0.001). Minor bleeding was significantly higher in the transseptal group with seven cases, compared to the nasal packing group without any bleeding cases ( p = 0.014). There were two patients who had postoperative major bleeding, and two patients who had septal hematoma in the transseptal suture group. One patient with nasal packing had postoperative infection. Septal perforation was not seen in any of the cases. While patients in both groups experienced postoperative crusting, patients in the transseptal suture group also complained about foreign body sensation. Extubation was more comfortable; post-anaesthesia monitorization duration was shorter, and postoperative pain was less, but minor bleeding was seen more with transseptal sutures. There was no significant difference in terms of major bleeding, hematoma, infection or perforation. Foreign body sensation was the main cause of postoperative discomfort in the transseptal suture group. Transseptal suturing might be a significantly comfortable, cost-effective and reliable alternative to nasal packing.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0937-4477 1434-4726
DOI:	10.1007/s00405-011-1542-x