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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-five patients undergoing routine nasal surgery were enrolled into a randomized, prospective trial to investigate the efficacy and morbidity of nasal packing. The patients were randomized to receive a bismuth iodoform paraffin paste (BIPP) pack, a Telfa pack or no pack. Patients for septal surgery were randomized between the BIPP and Telfa groups only. They were independently randomized to receive or not receive, a silastic nasal splint for the first post-operative week. Post-operative pain levels were analysed using a visual analogue scale. Mean pain scores were increased 50 per cent by the use of nasal packs and pack removal, particularly BIPP which, was a most painful event (p < 0.001). Reactionary haemorrhage occurred in only two patients (2.1 per cent), both of whom had packs in situ. Vestibulitis was unique to the patients with a silastic splint, who were packed with BIPP, occurring in 21 per cent of them. Similarly septal perforation was unique to this group. There was no significant difference in the incidence of adhesions between the groups which received packs and those who did not. Routine nasal packing, especially with BIPP, would seen difficult to justify in view of the increased pain levels and increased complications which occur without any demonstrable benefit in the majority of patients. Therefore packing should be reserved for cases where there is concern about persistent haemorrhage. In these cases Telfa would be preferable to BIPP.
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PMID:Nasal packing after routine nasal surgery--is it justified? 826 86

Systematic use of preoperative antibiotic prophylaxis (PAP) and nasal packing (NP) in septoplasty-both directly and indirectly affecting the cost of surgery (length of hospitalization)-appear based on controversial scientific data and, at times, even on unjustified clinical "habits". A controlled study was thus performed on 100 adults undergoing exclusive nasal septoplasty to determine whether these techniques are actually useful. The subjects were randomly divided into four groups: TN-PAP-(29 subjects), TN-PAP+ (25 subjects), TN+ PAP- (21 subjects) and TN+ PAP+ (25 subjects). Surgery was always performed by the same surgeon and was concluded with continuous suture of the mucoperichondrial layers. Only one patient (TN-PAP-) presented complications of infection (vestibulitis). Three patients in the TN- group required nasal packing a few hours after surgery because of moderate bleeding. As of three months after surgery no other complications had arisen. Postoperative pain, evaluated on an analogicalvisual scale, was higher during the 12 hours after surgery. Analysis of variance showed that the only pain-related factor was nasal packing while PAP and the interaction between TN and PAP did not prove significant. The above results suggest that PAP and TN should not be systematically used, thus reducing the hospitalization period for septoplasty to the day of surgery (Day surgery).
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PMID:[Nasal packing and antibiotic prophylaxis in septoplasty: a controlled study]. 984 18