Introduction
The nose and para nasal sinuses are anatomically known to be highly
vascular therefore a substantial amount of bleeding is expected from
rhinology surgeries. Ingested blood is known to be a powerful
emetic1,2, and the risk of aspirating blood into the
lungs is present due to the fact that an endotracheal tube is not 100%
effective in protecting the airway3,4. Post-operative
nausea and vomiting (PONV) is a frequent problem that is encountered in
surgical patients with a 4 to 6-fold increase in nasal and endoscopic
sinus operations1,4.
Posterior throat packs are often-used in rhinology surgery to help in
protecting the airway against aspiration and in the reduction of
ponv5. However, many studies concluded that posterior
throat packs are associated with higher amounts of post-operative pain,
nausea2,6,7, vomiting, and in some rare cases even
forgotten in the patient leading to mortality8.
Despite poor evidence in the literature, the placement of posterior
throat packs is commonly practiced by surgeons and anesthetists because
the possible risk of aspiration is worrisome 9.
A conventional throat pack consists of gauze, but an alternative
practice involves the pharyngeal placement of tampons. The objective of
this study is to evaluate and compare the post-operative throat pain,
nausea, and vomiting in patients that have been packed with either
conventional gauze throat packs or pharyngeal tampons.