The effect of prilocaine and prilocaine plus meperidine infiltration on the pain during nasal packing removal.
OBJECTIVE
Removing the nasal packing after nasal surgery is an uncomfortable and painful procedure. Since there is no controlled trial described in the literature about the local use of meperidine during packing removal, we aimed to compare the analgesic and sedative effects of the meperidine-prilocaine combination, injected into the packing 15 minutes before the procedure, with that of prilocaine during packing removal.


METHODS
Fifty adult patients, for whom nasal packing removal after nasal septoplasty was scheduled, were randomly allocated into one of two groups. In the prilocaine group (Group P, n = 25), 5 ml of 1% prilocaine in saline was injected into the pack 15 minutes before removal. In the prilocaine-meperidine group (Group MP, n = 25), 5 ml fluid combination containing prilocaine (10 mg/ml) and meperidine (1 mg/kg) was injected in nasal packs. Five ml saline was injected into the package in the contra-lateral nostril in both groups as control. Visual analogue scale (VAS) score was recorded during injections (t) and packing removal (t), and the Ramsay sedation score was evaluated.


RESULTS
VAS score was not different from the control nostril in Group P (p > 0.05), where as it was significantly lower than the control nostril in Group MP (p < 0.05). Ramsay sedation scores were significantly higher in Group MP compared to the control nostril and actively treated nostril of Group P (p < 0.05).


CONCLUSIONS
The injection of prilocaine plus meperidine into the nasal pack 15 minutes before nasal packing removal provides effective analgesia and mild sedation during the procedure.
Karaaslan
Kazim
K
Abant Izzet Baysal University, Faculty of Medicine, Department of Anesthesiology, Bolu, Turkey.
Yilmaz
Fahrettin
F
Gulcu
Nebahat
N
Yigit
Beyhan
B
Kocoglu
Hasan
H
D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D020878:Device Removal; D004338:Drug Combinations; D005260:Female; D005557:Formaldehyde; D006490:Hemostatics; D006801:Humans; D007267:Injections; D008297:Male; D008614:Meperidine / Q000008:administration & dosage*; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000601:surgery*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011142:Polyvinyl Alcohol; D011318:Prilocaine / Q000008:administration & dosage*; D012225:Rhinoplasty
D000701:Analgesics, Opioid; D004338:Drug Combinations; D006490:Hemostatics; D011318:Prilocaine; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol; D008614:Meperidine