A STUDY OF THE EFFECTIVENESS OF FENTANYL NASAL PACKS IN POSTOPERATIVE PAIN ASSESSMENT FOLLOWING FUNCTIONAL ENDOSCOPIC SINUS SURGERY
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Keywords
fentanyl nasal pack, endoscopic sinus, surgery
Abstract
Background: Nasal packing is usually performed to control bleeding after endoscopic sinus surgery (ESS). Although new packing materials have been developed, they still cause pain. This study was designed to evaluate the effect of lidocaine-soaked packs on pain after ESS.
Aim and objective: to evaluate the effect of fentanyl-soaked packing as a method of controlling pain after nasal surgeries in a prospective, randomized, double-blind controlled trial.
Methods: 52 patients who have undergone closed nasal bone fracture reduction surgery were included in this study. 26 patients were treated postoperatively with 50 mcg of fentanyl-soaked MerocelV, a biodegradable synthetic polyurethane foam, and the other 26 patients were treated with saline-soaked packings. To analyze the relative nasal pain control effect of fentanyl, the Numeric Rating Scale, patient satisfaction, and Ramsay Sedation Scale were used. Patients were closely monitored to record relevant cardiopulmonary indicators and the degree of adverse symptoms such as headaches or sore throats.
Results: The fentanyl group had a significantly lower Numeric Rating Scale and higher patient satisfaction for most of the time periods after operation (p <.05). The symptoms of headaches and sore throats were also significantly reduced. Ramsay Sedation Scale scores improved compared to the control group (p <.05). No significant differences in cardiopulmonary relevant indicators between the two experimental groups were observed (p >.05).
Conclusion: Fentanyl-soaked packing significantly decreased postoperative pain with no observable adverse effects. Our results demonstrate that topical fentanyl application to nasal packing is an effective method of postoperative pain control after closed nasal bone fracture reduction surgery.
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Dr. Nilamadhaba Prusty
Associate Professor, Department of ENT, FM MCH Balasore
Dr. Dillip Kumar Pradhan
Assistant Professor, Department of Medicine, PRM MCH, Baripada
Dr. Ansuman Pradhan
Assistant Professor, Dept of General Surgery, SJ MCH, Puri
Dr. Biswaranjan Prusty
Assistant Professor, Department of Medicine, DD