title: Audit of pain after nasal surgery.
abstract: In our department, nasal packs have traditionally remained in place for a period of 24 h after routine elective nasal surgery. We decided to determine whether reducing the duration of nasal packing from 24 h to 2 h would reduce postoperative pain without a concomitant increase in haemorrhagic complications. A series of 72 patients undergoing elective nasal surgery were randomised to have either nasal packs for 24 h (n = 39) or for 2 h (n = 33). Pain was assessed using a visual analogue scale with the nasal packs in place and on their removal. The incidence of haemorrhage was noted. The results showed a significant decrease in mean pain score (MPS) with the packs in place, from 3.4 (range 0.8-6.8) to 1.16 (range 0-2.5); (P < 0.001) and also on pack removal from 5.3 (range 1.2-7.9) to 2.6 (range 0-5.4); (P < 0.05). There was no postoperative haemorrhage in either group. A new standard of 2 h for routine nasal packing was set and our departmental protocols were changed accordingly. Results in a further 36 patients gave a MPS with the packs in place of 1.12 (range 0-3.2) and a MPS of 2.36 (range 0-6.7) on their removal. There was no statistical difference between these and our previous findings. We conclude that postoperative nasal packing for only 2 h rather than 24 h significantly reduces pain without a concomitant risk of haemorrhage.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, St Mary's Hospital, London.
authors.forename: D M
authors.initials: DM
authors.lastname: Thomas
authors.forename: P A
authors.initials: PA
authors.lastname: Tierney
authors.forename: D
authors.initials: D
authors.lastname: Samuel
authors.forename: K S
authors.initials: KS
authors.lastname: Patel
mesh_terms: D000328:Adult; D001458:Bandages / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009666:Nose / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology*; D011182:Postoperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage; D011184:Postoperative Period