Abstract
Objective
We purposed to compare the effects of certain local anesthetics soaked Merocel nasal packs on hemorrhage and pain after septoplasty.
Materials and methods
This study is a prospective double-blind study that was done in patients undergoing septoplasty. The study was created with 90 patients. All patients were divided into four groups. The each group was applied 2% lidocaine plus adrenaline, 2% tetracaine, 4% articaine plus adrenaline as study groups or 0.9% sodium chloride (NaCl) as control group in their Merocel packs after septoplasty. Verbal analog scale (VAS) was applied to all patients and the amount of postoperative hemorrhage was noted during postoperative period. The statistical analysis was performed using Student’s t test and Chi-square test on each patient group at each time point.
Results
The study groups (2% lidocaine plus adrenaline, 2% tetracaine and 4% articaine plus adrenaline groups) had significantly better pain scores versus control group in the 1st, 4th, 8th, 16th and 24th postoperative hours (p < 0.05). The articaine plus adrenaline group had better pain scores than the lidocaine plus adrenaline group, and the lidocaine plus adrenaline group had better pain scores than the tetracaine group in the postoperative first day. Also articaine plus adrenaline group had less postoperative bleeding rate than the lidocaine plus adrenaline, tetracaine and control groups (p < 0.05). There was no statistically significant difference between the lidocaine plus adrenaline, tetracaine and control groups in terms of postoperative hemorrhage (p > 0.05).
Conclusion
Topical articaine plus adrenaline application in the nasal packs can be safely used for less pain and bleeding following septoplasty.
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References
Karaman E, Gungor G, Alimoglu Y et al (2011) The effect of lidocaine, bupivacaine and ropivacaine in nasal packs on pain and hemorrhage after septoplasty. Eur Arch Otorhinolaryngol 268(5):685–689
Watson MG, Campbell JB, Shenoi PM (1989) Nasal surgery: does the type of nasal pack influence the results? Rhinology 27(2):105–111
Hesham A, Ghali A (2011) Rapid rhino versus merocel nasal packs in septal surgery. J Laryngol Otol 125(12):1244–1246
Madineh H, Amani S, Kabiri M, Karimi B (2017) Evaluation of the anesthetic effect of nasal mucosa with tetracaine 0.5% on hemodynamic changes and postoperative pain of septoplasty: a randomized controlled trial. J Adv Pharm Technol Res 8(4):116–119
Young AL, Leung GY, Cheng LL, Lau TT, Lam PT, Lam DS (2009) Randomised controlled trial on the effectiveness of lidocaine gel vs tetracaine drops as the sole topical anaesthetic agent for primary pterygium surgery. Eye (London) 23:1518–1523
Snoeck M (2012) Articaine: a review of its use for local and regional anesthesia. Local Reg Anesth 5:23–33
Eski E, Guvenç IA, Hızal E, Yılmaz I (2014) Effects of nasal pack use on surgical success in septoplasty. Kulak Burun Bogaz Ihtis Derg 24(4):206–210
Awan MS, Iqbal M (2008) Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 87:624–627
Orlandi RR, Lanza DC (2004) Is nasal packing necessary following endoscopic sinus surgery? Laryngoscope 114:1541–1544
Buchanan MA, Dunn GR, Macdougall GM (2005) A prospective double-blind randomized controlled trial of the effect of topical bupivacaine on post-operative pain in bilateral nasal surgery with bilateral nasal packs inserted. J Laryngol Otol 119(4):284–288
Erkul E, Babayigit M, Kuduban O (2010) Comparison of local anesthesia with articaine and lidocaine in septoplasty procedure. Am J Rhinol Allergy 24:123–126
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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name the institution/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Mutlu, V., Kaya, Z. Comparison of the effect of the lidocaine, tetracaine, and articaine application into nasal packs on pain and hemorrhage after septoplasty. Eur Arch Otorhinolaryngol 275, 2481–2485 (2018). https://doi.org/10.1007/s00405-018-5084-3
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DOI: https://doi.org/10.1007/s00405-018-5084-3