title: Pre-emptive analgesia for removal of nasal packing: A double-blind placebo controlled study.
abstract: OBJECTIVE
  The most frequent complaint of patients after septoplasty is severe pain felt during removal of nasal packing placed on the operation. Various methods have been described to decrease pain and to increase patient comfort during removal of nasal packing. However, these methods are not practical. There has been an increase in the number of studies on pre-emptive analgesia use for postoperative pain relief. The aim of this study was to determine whether pre-emptive analgesia decreased pain during removal of Merocel packs placed in septoplasties.
  
  
  METHODS
  This is a double-blind randomized, placebo-controlled study. The study included 121 patients who underwent elective septoplasty in our otorhinolaryngology clinic. The patients were randomly assigned into two groups: study and placebo groups. The study and placebo groups received two tablets of diflunisal 500 mg and placebo, respectively, two and a half hours before removal of nasal packing. Visual analog scale (VAS) values immediately after and 5 min after removal of nasal packing, effects of the procedure on patient comfort and its side-effects were evaluated separately.
  
  
  RESULTS
  VAS values immediately after the removal of nasal packs significantly decreased in the study group (p<0.001), but there was no significant difference in VAS values obtained after the procedure between the study and placebo groups. Patient discomforts were significantly lower in the diflunisal group (p<0.001).
  
  
  CONCLUSIONS
  It can be concluded that pre-emptive analgesia decreases pain during removal of nasal packing placed in septoplasties and increases patient comfort.
authors.affiliation: Baskent University, Faculty of Medicine, Department of Otorhinolaryngology, Ankara, Turkey. cuneytyilmazer@yahoo.com
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Yilmazer
authors.forename: Mesut
authors.initials: M
authors.lastname: Sener
authors.forename: Ismail
authors.initials: I
authors.lastname: Yilmaz
authors.forename: Alper Nabi
authors.initials: AN
authors.lastname: Erkan
authors.forename: Can Alper
authors.initials: CA
authors.lastname: Cagici
authors.forename: Asli
authors.initials: A
authors.lastname: Donmez
authors.forename: Gulnaz
authors.initials: G
authors.lastname: Arslan
authors.forename: Levent Naci
authors.initials: LN
authors.lastname: Ozluoglu
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004061:Diflunisal / Q000008:administration & dosage*; D004311:Double-Blind Method; D005557:Formaldehyde; D006490:Hemostatics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011142:Polyvinyl Alcohol; D011182:Postoperative Care / Q000379:methods*; D011292:Premedication; D012225:Rhinoplasty
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D004061:Diflunisal; D011142:Polyvinyl Alcohol