Nasopharyngeal versus hypopharyngeal packing during sino-nasal surgeries: Randomised controlled trial.

OBJECTIVES

Primary: To compare the severity of postoperative throat pain between patients who received a nasopharyngeal pack and those who received a hypopharyngeal pack during their sino-nasal surgery. Secondary: To assess the efficacy of using a nasopharyngeal pack in preventing postoperative nausea and vomiting (PONV) and to compare its result with patients who received a hypopharyngeal pack.

DESIGN

Prospective, randomised, controlled trial.

SETTING

Tertiary Hospital.

PARTICIPANTS

Forty-seven patients were evaluated. Eligible patients were randomly allocated into one of the two following groups: Group (A): hypopharyngeal packing during the surgery, or Group (B): nasopharyngeal packing during the surgery.

MAIN OUTCOME MEASURES: The blinded Patients from both groups were evaluated at 2 hours, 24 hours and 1 week after the surgery by a blinded assessor. Throat pain was assessed using the standardised numeric rating scale for pain from zero to ten. The presence of PONV, oedema, congestion and ulceration of the pharyngeal mucosa was recorded.

RESULTS

At 2 hours after the surgery, the median pain score for the nasopharyngeal group was less than the hypopharyngeal group (3.5 and 4.0, respectively), but this difference was not statistically significant (P = .195). Patients in both groups had the same median score (4.0) when throat pain was assessed 24 hours after surgery. The hypopharyngeal packing group has a lower incidence of PONV at 2 hours, 24 hours and 1 week, these differences were not statistically significant (P > .050). Pharyngeal ulceration was found in one patient from the hypopharyngeal group during the second assessment at 24 hours. No differences in the assessed pharyngeal physical signs were statistically significant at any of the assessment time points.

CONCLUSION

The location of the throat pack does not affect the early postoperative throat pain. The nasopharyngeal pack is a safe alternative for the hypopharyngeal pack if throat packing is indicated. There is a need for review of the available current evidence on throat packs and more adequately powered randomised controlled trials on a larger scale of participants.