Comparison of the Effects of Pharyngeal Packing and Gastric Aspiration with an Orogastric Tube on Postoperative Nausea, Vomiting and Sore Throat in Septorhinoplasty

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İstanbul Medical Journal, vol.24, no.2, pp.196-203, 2023 (Peer-Reviewed Journal) identifier


Introduction: We compared the effects of pharyngeal packing and gastric decompression with orogastric tube application on the incidence of nausea/vomiting, sore throat, and dysphagia. As a secondary objective, we assessed the effect of the selected method on the postoperative pain score and patient satisfaction. Methods: In this randomized, prospective study were 60 patients aged 18-50 years who underwent elective septorhinoplasty. Nasopharyngeal packing was performed in group 1 and gastric decompression with an orogastric tube in group 2, and both procedures were terminated by the practitioner before extubation. Between-group demographic data, duration of operation/ anesthesia, hemodynamic parameters, nausea, vomiting, additional antiemetic requirement, pain/dysphagia during swallowing, visual analogue scale (VAS), and patient satisfaction were measured at 24 h, and the group findings were compared. Results: The demographic findings and durations of anesthesia/operation were not statistically different between the groups, and there was no difference in postoperative nausea and vomiting, VAS, and satisfaction scores. In contrast, sore throat was twice as common in the nasopharyngeal pack group but decreased over time. Conclusion: The routine packing approach should be abandoned by anesthesiologists. Because pharyngeal packing is not a completely risk-free procedure, we do not recommend intraoperative packing during nasal surgery. If indicated for surgical reasons, however, protocols, checklists, and observation forms pre-prepared with the participation of the surgical and anesthesia teams should be used. All materials should be included in the surgical (scrub) count, and it should be ensured that all materials are removed before extubation with a matching count. Regardless of the method used, it should not be forgotten that the anesthesiologist is responsible for the examination of the oral cavity and throat via direct laryngoscopy and, if necessary, aspiration before extubation.