Comparative study of complete nasal packing with and without airways.

OBJECTIVE

To study and compare the effects of complete nasal packing and nasal packing with airways (uni/bilateral) on blood pressure, arterial oxygen saturation, middle ear pressure, and post-operative subjective complaints.

METHODS

Ninety patients who underwent bilateral anterior nasal packing for epistaxis or following nasal surgery were divided into three equal groups by randomization. Group A received bilateral complete nasal packing, without an airway. In the other two groups, an airway designed from a poly-vinyl chloride, uncuffed endotracheal tube (number 5) was placed below the nasal pack between the inferior turbinate and septum on one (Group B) or both sides (Group C) of the nasal cavity. Patients were monitored in the ward when asleep, especially overnight, for blood pressure and SpO2 levels.

RESULTS

Almost all patients in Group A had nasal obstruction with dry mouth, difficulty swallowing, and disturbed sleep. Only 33-40% patients in Groups B and C had similar complaints. Blood pressure rose > 20 mm of Hg in 20 (67%) patients in Group A, while no patients in the airway groups showed any change in blood pressure. In Group A, the average SpO2 during sleep decreased > 4% from baseline in 10 (33%) patients and negative middle ear pressure was found in 5 (17%) patients. The SpO2 and middle ear pressure was within normal limits for all patients with airway packing.

CONCLUSIONS

Nasal packing with an airway may help to reduce post operative morbidity and reduce the risk of hypoxemia.