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Review of the use of throat packs in nasal surgery

Published online by Cambridge University Press:  04 February 2009

V Jaiswal  and
G C Bedford
V Jaiswal*
Affiliation:
Department of Ear, Nose and Throat Surgery, Freeman Hospital, Newcastle Upon Tyne, UK
G C Bedford
Affiliation:
Department of Anaesthesia, Freeman Hospital, Newcastle Upon Tyne, UK
*
Address for correspondence: Miss Vibha Jaiswal, ST2 ENT, ENT Department, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DU, UK. Fax: +44 (0)191 223 1246 E-mail: vibhaj@doctors.org.uk
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Abstract

Background:

Throat packs are employed in nasal surgery to prevent contamination of the upper aerodigestive tract. Their use is thought to reduce the risk of aspiration and post-operative nausea and vomiting. However, use of throat packs may also be accompanied by increased throat pain. In order to inform our clinical practice, the evidence base for throat pack insertion was reviewed.

Method:

A search was made of the Pubmed database from the 1950s to March 2008. Four randomised, controlled, clinical trials were reviewed.

Results:

All the trials had significant methodological weakness. In all but one, no power calculations were done. There were inconsistencies in the measurement of pain and heterogeneity of rhinological procedures. The one adequately powered trial could not demonstrate a difference in post-operative nausea and vomiting with the use of throat packs (β error = 20 per cent).

Conclusion:

Further, adequately powered trials are required involving patients undergoing rhinological procedures with a higher risk of blood contamination (e.g. functional endoscopic sinus surgery), in order to provide definitive evidence on the morbidity of throat packs in rhinological procedures.

Keywords

PharynxPainInhalationPostoperative PeriodNauseaVomitingNoseSurgical Procedures, OperativeSurgeryAnesthetics, General
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 701 - 704
Copyright
Copyright © JLO (1984) Limited 2009

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References

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