Effect of Fentanyl Nasal Packing Treatment on Patients With Acute Postoperative Pain After Nasal Operation: A Randomized Double-Blind Controlled Trial.

TitleEffect of Fentanyl Nasal Packing Treatment on Patients With Acute Postoperative Pain After Nasal Operation: A Randomized Double-Blind Controlled Trial.
Publication TypeJournal Article
Year of Publication2018
AuthorsKim K-S, Yeo N-K, Kim S-S, Park W-S, Kwak S-H, Cho S-H, Sung G-W, Kim H-S, Yi S-W, Cho HJun
JournalAnn Otol Rhinol Laryngol
Volume127
Issue5
Pagination297-305
Date Published2018 May
ISSN1943-572X
KeywordsAbsorbable Implants, Administration, Topical, Adult, Analgesics, Opioid, Double-Blind Method, Endoscopy, Female, Fentanyl, Headache, Humans, Male, Middle Aged, Nasal Septum, Occlusive Dressings, Pain Measurement, Pain, Postoperative, Paranasal Sinuses, Patient Satisfaction, Pharyngitis, Polyurethanes, Postoperative Complications, Prospective Studies, Rhinitis, Sinusitis
Abstract

PURPOSE: Nasal packing is an option for bleeding control after endoscopic sinus surgery and septoplasty. Although new packing materials have been developed, patients still suffer from pain and require additional analgesics treatments. In this study, a prospective, randomized, and double-blind controlled trial was designed to evaluate the effect of fentanyl-soaked packing on pain after endoscopic sinus surgery and septoplasty.

METHODS: One hundred fifty-two patients who underwent nasal surgeries due to chronic rhinosinusitis or nasal septal deviation were enrolled in this study. At the end of operation, 50 mcg fentanyl-soaked biodegradable synthetic polyurethane foams packing Nasopore or Merocel were applied to a group of 79 patients, and saline-soaked ones were applied to another group of 73 patients. To evaluate the influence of fentanyl on postoperative nasal pain, patients' conditions were assessed via means of Numeric Rating Scale, patient satisfaction, and Ramsay Sedation Scale. In addition, symptoms of headache or sore throat and any signs of cardiopulmonary-relevant indicators were monitored.

RESULTS: The fentanyl group had significantly decreased Numeric Rating Scale and increased patient satisfaction in every operation type for the majority of postoperative time periods ( P < .05) with reduced postoperative headache and sore throat compared to the control group. The fentanyl group showed a higher score on Ramsay Sedation Scale than the control group ( P < .05 in group including endoscopic sinus surgery). There were no significant differences in cardiopulmonary-relevant indicators between the 2 groups ( P > .05).

CONCLUSION: Fentanyl group showed significantly reduced postoperative pain without serious adverse effects. We suggest that topical fentanyl application to nasal packs can be a useful method to reduce pain during the early postoperative period after endoscopic sinus surgery and septoplasty.

DOI10.1177/0003489418759113
Alternate JournalAnn. Otol. Rhinol. Laryngol.
PubMed ID29519133

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