Discussion
There is no evidence to suggest that using pharyngeal tampons reduces
the mean VAS score at 1[t87=1.368, p=0.175] or 24 hours
[t87=0.310, p=0.757], compared to using Gauze. There is evidence to
suggest that using pharyngeal tampons reduces the mean VAS score at 4
hours [t87=3.294, p=0.001] compared to using gauze.
The pattern of data shows that the tampon is better than gauze in terms
of VAS. 25 out of 43 patients using tampons had low VAS scores after 24
hours, whereas 23 out of 46 patients using gauze had low VAS scores
after 24 hours.
There is no evidence to suggest that using pharyngeal tampons reduces
the mean PONV score at 1 [t87=1.389, p=0.168] , 4
[t87=-0.247, p=0.806] and 24 hours
[t87=0.389, p=0.698], compared to using Gauze.
The pattern of data shows that the tampon is equivalent to gauze in
terms of PONV. 36 out of 43 patients using tampons had a low PONV score
after 24 hours, and 39 out of 46 patients using gauze showed similar
scores
There is limited research on the use of pharyngeal tampons in rhinology
procedures. Marais and Prescott (1993) showed that the use pharyngeal
tampons are associated with a decreased amount of post-operative throat
pain, when compared to conventional gauze throat
packs12. A research paper by Green et al (2017)
advises against the use of…. conventional pharyngeal packs due to
higher incidences of post-operative pain9. Our study
shows that pharyngeal tampon placement is associated with decreased
amount of pain and could be suitable alternative to conventional ribbon
gauze packs.
We could not find any studies that compared the post-operative nausea
and vomiting in the two different types of throat packs, however in
Basha et al (2006), they established that packing the
patient with conventional ribbon gauze was associated with a higher
chance of post-operative nausea and vomiting immediately
post-op13. Piltcher et (2007) al comparedp ost-operative nausea and vomiting in packed and unpackedprocedures and came to the conclusion that there is no difference
in throat pain or PONV1. Our study concluded that use
of tampons is equivalent to gauze in terms of PONV.
Our study was dependent on subjective methods of assessment thus
each patient experienced a different degree of pain and PONV. Patients
around the 1-hour post -operative mark were still under theresidual effects of anesthesia and analgesia which would
Heavily skew their assessment. Also, although the cases were done
under the care of a single surgeon, the anaesthetic management was not.The method of throat pack application was not standardized for the
study and as in adding an unforeseen variable to the scoring of the .
Our study would have benefited from a larger population and further
studies should be carried out in order to confirm our results.