Do totally occlusive nasal packs after nasal surgery increase the risk of immediate respiratory distress during recovery from anesthesia?
OBJECTIVE
This study aims to compare the risk of immediate respiratory distress (IRD) during the recovery of anesthesia between the nasal surgery with totally occlusive nasal packing and non-respiratory tract-related surgeries.


METHODS
A total of 300 patients (180 males, 120 females; mean age 30.1±8.2 years; range 18 to 52 years) were included in the study. The patients were assigned to one of two age- and sex-matched groups according to surgery type: 1) patients undergoing nasal surgery with totally occlusive nasal packs for nasal septum deviation or 2) patients undergoing non-respiratory tract surgeries for various diseases. Immediate respiratory distress was defined as any unanticipated hypoxemia, hypoventilation or upper-airway obstruction (stridor or laryngospasm) requiring an active and specific intervention.


RESULTS
The patients who underwent nasal surgery with totally occlusive nasal packs had a 6.25 times higher risk of IRD than the patients who underwent non-respiratory tract surgery during recovery from general anesthesia. Smokers had a 4.8 times higher risk of having IRD than non-smokers during the post-extubation phase. There were no significant differences in the incidence of IRD between males and females.


CONCLUSIONS
Based on our study results, totally occlusive nasal packs and smoking were associated with poor extubation status at the end of the surgical procedure.
Department of Otolaryngology, Amasya University, Sabuncuoğlu Şerefeddin Training and Research Hospital, 05200 Amasya, Turkey. melihcayonu@yahoo.com.
Melih
M
Çayönü
Dursun Fırat
DF
Ergül
Mehmet
M
Çelik
Funda
F
Durmaz
Arif Hikmet
AH
Çatakoğlu
Mustafa
M
Erdoğan
D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D004417:Dyspnea / Q000209:etiology*; D004844:Epistaxis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D059747:Nasal Surgical Procedures; D012306:Risk; D012907:Smoking; D013630:Tampons, Surgical / Q000009:adverse effects*; D055815:Young Adult