Sore throat patients after oral and maxillofacial surgery with and without pharyngeal pack
Sore Throat after Oral and Maxillofacial Surgeries
,
Abstract
Background: Pharyngeal packing is now widely used in head and neck surgeries after induction of anesthesia. Therefore, the present study was designed to investigate the effect of pharyngeal packing on the occurrence of sore throat and other associated symptoms in comparison with patients without pharyngeal pack in orthognathic surgeries.
Materials and methods: This study was a randomized clinical trial and the target population was patients undergoing maxillofacial surgery hospitalized in two centers, Shafa and Shahid Bahonar Hospitals in Kerman. Sixty patients assigned to two groups, including the group with saline-soaked pack and the group without the pharyngeal pack, were evaluated for the severity of sore throat at time intervals of 2, 6, 12, and 24 hours after surgery as well as the occurrence of comorbid symptoms.
Results: There was no significant difference between the two groups in terms of demographic indicators, length of surgery, and length of recovery. The severity of sore throat at all-time intervals was significantly higher in the pharyngeal pack group in comparison to the control group. Other symptoms such as dysphagia, hoarseness, nausea and vomiting, laryngeal spasm, and cough were not significantly different between the two groups.
Conclusions: The findings of the present study showed that the use of pharyngeal was associated with an increase in the severity of sore throat but had no effect on the associated symptoms. These findings can be a guide to adopting the correct approach to the use of pharyngeal packs in patients undergoing maxillofacial surgery.
1. Gupta A, Sharma R, Gupta N. Throat pack:“Friend or foe” for anesthesiologist. J Anaesthesiol Crit Care. 2018;1(2):7.
2. Shaw I, Kumar C, Dodds C. Oxford textbook of anaesthesia for oral and maxillofacial surgery: Oxford University Press, USA; 2010.
3. Athanassoglou V, Patel A, McGuire B, Higgs A, Dover M, Brennan P, et al. Systematic review of benefits or harms of routine anaesthetist‐inserted throat packs in adults: practice recommendations for inserting and counting throat packs: An evidence‐based consensus statement by the Difficult Airway Society (DAS), the British Association of Oral and Maxillofacial Surgery (BAOMS) and the British Association of Otorhinolaryngology, Head and Neck Surgery (ENT‐UK). Anaesthesia. 2018;73(5):612-8.
4. Smith M, Turnbull D, Andrzejowski J. Throat packs in neuroanaesthesia. Anaesthesia. 2012;67(7):804-5.
5. Hariharan D, Lobo D. Retained surgical sponges, needles and instruments. The Annals of the Royal College of Surgeons of England. 2013;95(2):87-92.
6. Stone JP, Collyer J. Aide-memoir to pharyngeal pack removal. Anesthesia & Analgesia. 2003;96(1):304.
7. Kinthala S, Mudaraddi R, Johnny KT. Novel method to prevent the inadvertent retention of throat pack. Anesthesia & Analgesia. 2012;114(3):701.
8. Colbert S, Jackson M, Turner M, Brennan P. Reducing the risk of retained throat packs after surgery. British Journal of Oral and Maxillofacial Surgery. 2012;50(7):680-1.
9. Faro T, e Silva EdO, Campos G, Duarte N, Caetano A, Laureano Filho J. Effects of throat packs during orthognathic surgery: a double-blind randomized controlled clinical trial. International Journal of Oral and Maxillofacial Surgery. 2021;50(3):349-55.
10. Biro P, Seifert B, Pasch T. Complaints of sore throat after tracheal intubation: a prospective evaluation. European journal of anaesthesiology. 2005;22(4):307-11.
11. Fine J, Kaltman S, Bianco M. Prevention of sore throat after nasotracheal intubation. Journal of Oral and Maxillofacial Surgery. 1988;46(11):946-7.
12. MR S. < The> comparison of beclomethasone inhaler and intravenous lidocaine in prevention of postoperative airway and throat complaints. 2008.
13. El‐Boghdadly K, Bailey C, Wiles M. Postoperative sore throat: a systematic review. Anaesthesia. 2016;71(6):706-17.
14. Solatpour F, Teymourian H, Mohajerani SA, Shirazi FH, Zadeh SL, Baikpour M, et al. Comparison of the incidence of sore throat after rapid sequence intubation with succinylcholine and cisatracurium. Anesthesiology and pain medicine. 2014;4(3).
15. Tanaka Y, Nakayama T, Nishimori M, Tsujimura Y, Kawaguchi M, Sato Y. Lidocaine for preventing postoperative sore throat. Cochrane database of systematic reviews. 2015(7).
16. Rizvi MM, Singh RB, Rasheed MA, Sarkar A. Effects of different types of pharyngeal packing in patients undergoing nasal surgery: A comparative study. Anesthesia, Essays and Researches. 2015;9(2):230.
17. Alvi N. A survey about throat pack management in perioperative period. J Anesth Clin Res. 2016;7(664):2.
18. Apfel C, Heidrich F, Jukar-Rao S, Jalota L, Hornuss C, Whelan R, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. British journal of anaesthesia. 2012;109(5):742-53.
19. Silva AC, O’Ryan F, Poor DB. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review. Journal of oral and maxillofacial surgery. 2006;64(9):1385-97.
20. Bajwa SJS. Prevention of aspiration of blood with a unique pharyngeal packing method. Anesthesia, Essays and Researches. 2012;6(2):251.
21. Ku C, Ong B. Postoperative nausea and vomiting: a review of current literature. Singapore medical journal. 2003;44(7):366-74.
22. Basha S, McCoy E, Ullah R, Kinsella J. The efficacy of pharyngeal packing during routine nasal surgery–a prospective randomised controlled study. Anaesthesia. 2006;61(12):1161-5.
23. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine. 2001;8(12):1153-7.
24. Jin HJ, Kim S, Hwang SH. Can pharyngeal packing prevent postoperative nausea and vomiting in nasal surgery? The Laryngoscope. 2019;129(2):291-8.
25. Al-Lami A, Amonoo-Kuofi K, Kulloo P, Lakhani R, Prakash N, Bhat N. A study evaluating the effects of throat packs during nasal surgery: a randomised controlled trial. European Archives of Oto-Rhino-Laryngology. 2017;274:3109-14.
26. Karbasforushan A, Hemmatpoor B, Makhsosi BR, Mahvar T, Golfam P, Khiabani B. The effect of pharyngeal packing during nasal surgery on the incidence of post operative nausea, vomiting, and sore throat. Iranian journal of otorhinolaryngology. 2014;26(77):219.
27. Green R, Konuthula N, Sobrero M, Saini A, Parasher A, Pool C, et al. Use of pharyngeal packs in functional endoscopic sinus surgery: a randomized controlled trial. The Laryngoscope. 2017;127(11):2460-5.
28. Powell K, Amin D, Sesanto R, Bryant A, Kukreja P, Waite P. Do oropharyngeal throat packs prevent fluid ingestion during orthognathic surgery? International Journal of Oral and Maxillofacial Surgery. 2022;51(3):366-70.
29. Ghosh S, Rai KK, Shivakumar HR, Upasi AP, Naik VG, Bharat A. Incidence and risk factors for postoperative nausea and vomiting in orthognathic surgery: a 10-year retrospective study. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2020;46(2):116.
30. Phillips C, Brookes CD, Rich J, Arbon J, Turvey T. Postoperative nausea and vomiting following orthognathic surgery. International journal of oral and maxillofacial surgery. 2015;44(6):745-51.
31. Salmon BA, Dawlatly A, Van Sickels JE. Dysphagia requiring nasogastric feeding following orthognathic surgery: an unusual complication, case report, literature review, and recommendations. Journal of Oral and Maxillofacial Surgery. 2019;77(3):601-6.
32. Nagler R, Peled M, Laufer D. Prolonged dysphagia after orthognathic surgery: report of a case and review of the literature. Journal of oral and maxillofacial surgery. 1996;54(4):523-5.
33. Meco BC, Ozcelik M, Yildirim Guclu C, Beton S, Islamoglu Y, Turgay A, et al. Does type of pharyngeal packing during sinonasal surgery have an effect on PONV and throat pain? Otolaryngology--Head and Neck Surgery. 2016;154(4):742-7.
34. Erkalp K, Korkut YA, Meric A, Kahya V, Gedikli O, Su OK, et al. Pharyngeal packing is a predisposing factor for postoperative aphthous stomatitis in nasal surgery. Otolaryngology—Head and Neck Surgery. 2010;142(5):672-6.
35. Sharma PK, Bhakta P, Srinivasan S, Khan RM, Kaul N. Acute tongue enlargement secondary to pharyngeal packing after tracheal intubation. Middle Eastern Journal of Anesthesiology. 2012;21:761-4.
36. Knepil GJ, Blackburn C. Retained throat packs: results of a national survey and the application of an organisational accident model. British Journal of Oral and Maxillofacial Surgery. 2008;46(6):473-6.
2. Shaw I, Kumar C, Dodds C. Oxford textbook of anaesthesia for oral and maxillofacial surgery: Oxford University Press, USA; 2010.
3. Athanassoglou V, Patel A, McGuire B, Higgs A, Dover M, Brennan P, et al. Systematic review of benefits or harms of routine anaesthetist‐inserted throat packs in adults: practice recommendations for inserting and counting throat packs: An evidence‐based consensus statement by the Difficult Airway Society (DAS), the British Association of Oral and Maxillofacial Surgery (BAOMS) and the British Association of Otorhinolaryngology, Head and Neck Surgery (ENT‐UK). Anaesthesia. 2018;73(5):612-8.
4. Smith M, Turnbull D, Andrzejowski J. Throat packs in neuroanaesthesia. Anaesthesia. 2012;67(7):804-5.
5. Hariharan D, Lobo D. Retained surgical sponges, needles and instruments. The Annals of the Royal College of Surgeons of England. 2013;95(2):87-92.
6. Stone JP, Collyer J. Aide-memoir to pharyngeal pack removal. Anesthesia & Analgesia. 2003;96(1):304.
7. Kinthala S, Mudaraddi R, Johnny KT. Novel method to prevent the inadvertent retention of throat pack. Anesthesia & Analgesia. 2012;114(3):701.
8. Colbert S, Jackson M, Turner M, Brennan P. Reducing the risk of retained throat packs after surgery. British Journal of Oral and Maxillofacial Surgery. 2012;50(7):680-1.
9. Faro T, e Silva EdO, Campos G, Duarte N, Caetano A, Laureano Filho J. Effects of throat packs during orthognathic surgery: a double-blind randomized controlled clinical trial. International Journal of Oral and Maxillofacial Surgery. 2021;50(3):349-55.
10. Biro P, Seifert B, Pasch T. Complaints of sore throat after tracheal intubation: a prospective evaluation. European journal of anaesthesiology. 2005;22(4):307-11.
11. Fine J, Kaltman S, Bianco M. Prevention of sore throat after nasotracheal intubation. Journal of Oral and Maxillofacial Surgery. 1988;46(11):946-7.
12. MR S. < The> comparison of beclomethasone inhaler and intravenous lidocaine in prevention of postoperative airway and throat complaints. 2008.
13. El‐Boghdadly K, Bailey C, Wiles M. Postoperative sore throat: a systematic review. Anaesthesia. 2016;71(6):706-17.
14. Solatpour F, Teymourian H, Mohajerani SA, Shirazi FH, Zadeh SL, Baikpour M, et al. Comparison of the incidence of sore throat after rapid sequence intubation with succinylcholine and cisatracurium. Anesthesiology and pain medicine. 2014;4(3).
15. Tanaka Y, Nakayama T, Nishimori M, Tsujimura Y, Kawaguchi M, Sato Y. Lidocaine for preventing postoperative sore throat. Cochrane database of systematic reviews. 2015(7).
16. Rizvi MM, Singh RB, Rasheed MA, Sarkar A. Effects of different types of pharyngeal packing in patients undergoing nasal surgery: A comparative study. Anesthesia, Essays and Researches. 2015;9(2):230.
17. Alvi N. A survey about throat pack management in perioperative period. J Anesth Clin Res. 2016;7(664):2.
18. Apfel C, Heidrich F, Jukar-Rao S, Jalota L, Hornuss C, Whelan R, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. British journal of anaesthesia. 2012;109(5):742-53.
19. Silva AC, O’Ryan F, Poor DB. Postoperative nausea and vomiting (PONV) after orthognathic surgery: a retrospective study and literature review. Journal of oral and maxillofacial surgery. 2006;64(9):1385-97.
20. Bajwa SJS. Prevention of aspiration of blood with a unique pharyngeal packing method. Anesthesia, Essays and Researches. 2012;6(2):251.
21. Ku C, Ong B. Postoperative nausea and vomiting: a review of current literature. Singapore medical journal. 2003;44(7):366-74.
22. Basha S, McCoy E, Ullah R, Kinsella J. The efficacy of pharyngeal packing during routine nasal surgery–a prospective randomised controlled study. Anaesthesia. 2006;61(12):1161-5.
23. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine. 2001;8(12):1153-7.
24. Jin HJ, Kim S, Hwang SH. Can pharyngeal packing prevent postoperative nausea and vomiting in nasal surgery? The Laryngoscope. 2019;129(2):291-8.
25. Al-Lami A, Amonoo-Kuofi K, Kulloo P, Lakhani R, Prakash N, Bhat N. A study evaluating the effects of throat packs during nasal surgery: a randomised controlled trial. European Archives of Oto-Rhino-Laryngology. 2017;274:3109-14.
26. Karbasforushan A, Hemmatpoor B, Makhsosi BR, Mahvar T, Golfam P, Khiabani B. The effect of pharyngeal packing during nasal surgery on the incidence of post operative nausea, vomiting, and sore throat. Iranian journal of otorhinolaryngology. 2014;26(77):219.
27. Green R, Konuthula N, Sobrero M, Saini A, Parasher A, Pool C, et al. Use of pharyngeal packs in functional endoscopic sinus surgery: a randomized controlled trial. The Laryngoscope. 2017;127(11):2460-5.
28. Powell K, Amin D, Sesanto R, Bryant A, Kukreja P, Waite P. Do oropharyngeal throat packs prevent fluid ingestion during orthognathic surgery? International Journal of Oral and Maxillofacial Surgery. 2022;51(3):366-70.
29. Ghosh S, Rai KK, Shivakumar HR, Upasi AP, Naik VG, Bharat A. Incidence and risk factors for postoperative nausea and vomiting in orthognathic surgery: a 10-year retrospective study. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2020;46(2):116.
30. Phillips C, Brookes CD, Rich J, Arbon J, Turvey T. Postoperative nausea and vomiting following orthognathic surgery. International journal of oral and maxillofacial surgery. 2015;44(6):745-51.
31. Salmon BA, Dawlatly A, Van Sickels JE. Dysphagia requiring nasogastric feeding following orthognathic surgery: an unusual complication, case report, literature review, and recommendations. Journal of Oral and Maxillofacial Surgery. 2019;77(3):601-6.
32. Nagler R, Peled M, Laufer D. Prolonged dysphagia after orthognathic surgery: report of a case and review of the literature. Journal of oral and maxillofacial surgery. 1996;54(4):523-5.
33. Meco BC, Ozcelik M, Yildirim Guclu C, Beton S, Islamoglu Y, Turgay A, et al. Does type of pharyngeal packing during sinonasal surgery have an effect on PONV and throat pain? Otolaryngology--Head and Neck Surgery. 2016;154(4):742-7.
34. Erkalp K, Korkut YA, Meric A, Kahya V, Gedikli O, Su OK, et al. Pharyngeal packing is a predisposing factor for postoperative aphthous stomatitis in nasal surgery. Otolaryngology—Head and Neck Surgery. 2010;142(5):672-6.
35. Sharma PK, Bhakta P, Srinivasan S, Khan RM, Kaul N. Acute tongue enlargement secondary to pharyngeal packing after tracheal intubation. Middle Eastern Journal of Anesthesiology. 2012;21:761-4.
36. Knepil GJ, Blackburn C. Retained throat packs: results of a national survey and the application of an organisational accident model. British Journal of Oral and Maxillofacial Surgery. 2008;46(6):473-6.
| Files | ||
| Issue | Vol 7 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ajs.v7i2.16365 | |
| Keywords | ||
| Pharyngeal pack Jaw surgery Throat pain Anesthesia | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
aminaie mana, tahami tina, Mahmoodi M. Sore throat patients after oral and maxillofacial surgery with and without pharyngeal pack. AJS. 2024;7(2):52-58.
