Current practices and beliefs regarding the use of oropharyngeal throat pack in India

Gupta, Anju; Sarma, Riniki; Gupta, Nishkarsh; Kumar, Rakesh

doi:10.4103/ija.ija_1376_20

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…4 A variety of suggestions have been formulated to prevent the detrimental consequences of TP retention, yet over half of the individuals in our research sample followed a TP insertion protocol established by the institution. 1 As in the earlier study by Knepil et al, the majority of our study participants agreed that the either team was in charge of inserting the TP. 2 The insertion of TP was most commonly performed using Magill forceps and either a direct laryngoscope (49.3%) or a video laryngoscope (39.2%).…”

Section: Discussionsupporting

confidence: 73%

“…Its purpose is to prevent the downward flow of secretions, blood, or tissue debris into the stomach or trachea. 1 While the majority of our participants believed that TP usage effectively prevents the entry of blood or secretions into the trachea, it has been demonstrated that pharyngeal packing does not offer complete protection. 4 A variety of suggestions have been formulated to prevent the detrimental consequences of TP retention, yet over half of the individuals in our research sample followed a TP insertion protocol established by the institution.…”

Section: Discussionmentioning

confidence: 81%

“…The responsibility for the insertion and removal of TP, as well as the implementation of measures to prevent TP retention, remains a topic of debate without a clear consensus. [1][2][3] The ingestion of blood is known to induce vomiting, while the aspiration of blood can result in inflammation, both of which may cause delays in hospitalization. Additionally, there is a lack of Indian data regarding the prevalence of TP usage, the incidence of adverse events associated with their use, and guidelines for preventing TP retention.…”

Section: Introductionmentioning

confidence: 99%

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The application of an oropharyngeal throat pack in maxillofacial surgeries in Marathwada region

Gavali,

Landge,

Shah

et al. 2024

JOOO

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The objective of the research was to investigate the utilization of oropharyngeal throat pack during maxillofacial surgeries at various institutions in Maharashtra.A randomized prospective survey was conducted using a total of 139 anonymous questionnaires to investigate the utilization, attitudes, experiences, and mindsets of anesthesiologists (n = 53) and surgeons (n = 86). The study solely relied on questionnaire-based observations and did not involve any clinical research.46.33% of individuals provided their responses. The utilization of Throat Pack (TP) is infrequent or non-existent among less than 33% of surgeons and slightly more than 33% of anaesthesiologists. Around 50% of the participating surgeons acknowledged being aware of 1 to 4 nonfatal adverse events. Notably, there exists a notable disparity in viewpoints concerning the removal of Throat Pack and the ultimate responsibility for its removal.Throat packs are commonly employed in maxillofacial surgeries. Moreover, it seems that despite recent advancements, there might still exist a divergence of viewpoints among the surgical and anaesthesiology teams concerning specific responsibilities.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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The application of an oropharyngeal throat pack in maxillofacial surgeries in Marathwada region

Gavali,

Landge,

Shah

et al. 2024

JOOO

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“…Over-insertion of OPTPs reportedly leads to acute tongue hypertrophy [ 11 , 12 ]. The most serious disadvantage of using OPTPs is the risk of accidental retention, potentially resulting in fatal airway obstruction after extubation when OPTPs are not removed [ 1 , 2 , 4 , 7 , 13 ]. A survey of all acute NHS trusts in the United Kingdom reported six cases of OPTP retention over three years [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Survey on the Awareness of the Use of Oropharyngeal Throat Packs in Dental Anesthesia: An International Online Survey

Yamaguchi,

Tsukimoto,

Kuroda

et al. 2024

Cureus

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Introduction: Oropharyngeal throat packs (OPTPs) are frequently used to administer general anesthesia during oral surgery and dental procedures. However, the use of OPTPs has remained controversial, with concerns about their effectiveness, the potential for falling short of expectations, and the inherent risk of serious oversight in removing them. This study aimed to assess the awareness of dental anesthesiologists in the United States of America (USA) and Japan regarding the use of OPTPs. Methods: An online questionnaire was distributed to 41 dental anesthesia education facilities in May 2023 and responses were obtained from 32 facilities. Results: The responses to the questionnaire indicated that dental anesthesiologists in both the USA and Japan believe that using OPTPs during general anesthesia with airway securement is of significant importance, albeit with varying primary purposes for their application. In contrast, notable disparities were observed between the USA and Japan regarding the perceived importance and routine use of OPTPs during open-airway general anesthesia. In both countries, there is a common understanding that the residual risks of OPTPs are severe and that multiple preventive procedures are required. Conclusions: The present study showed that dental anesthesiologists in the USA and Japan believed that the use of OPTPs was generally necessary for dental anesthesia. However, there was a difference in awareness between Japan and the USA regarding the importance of OPTPs for open-airway general anesthesia. Therefore, there should be a consensus among dental anesthesiologists in Japan and the USA on using OPTPs during open-airway general anesthesia in the near future.

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“…Many cases of missing TPs have been reported in earlier literature (14)(15)(16)(17)(18). Ninety-three (38.27%) Indian anesthesiologists participated in a nationwide survey had encountered retained TP which led to airway obstruction in 37.6% cases (19), while 42 respondents of a national survey in the UK reported 52 critical incidents of retained TP (2). In some cases, the missing TP was found and retrieved soon after the surgery, under endoscopy or vomited out by the patient.…”

Section: What Is the Implication And What Should Change Now?mentioning

confidence: 99%

Suggestions on management process of throat pack in orthognathic surgery: a case report and literature review

Zhao¹,

Jiang²,

Chi³

et al. 2023

Front Oral Maxillofac Med

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Background: Throat packs are commonly used in oral surgeries to prevent accidental aspiration or ingestion. However, a forgotten throat pack can be the cause of serious postoperative complications.Although plenty of recording and warning methods have been applied, such incidents are still reported from time to time. Lack of striking marks or communication within the team is the main cause of a forgotten throat pack, and extubation before checking the number of gauzes will likely cause the throat pack to remain in the body. After literature review, quite a few related cases and precaution are available for searching, yet there is no standardized process for the use of throat pack in orthognathic surgery at present.Case Description: This article reported a case in which the throat pack was lost and retrieved relying on the good teamwork and imaging methods. The patient was a 26-year-old female undergoing bimaxillary surgery for skeletal Class III malocclusion. The throat pack was missing after wound closure. Under the guidance of maxillofacial computed tomography (CT), the throat pack was found in her right nasopharynx, the patient was extubated and recovered uneventfully.Conclusions: This paper reviewed the use of throat packs and its iatrogenic complications, summarized the experience based on this case and earlier literature, and formulated a standardized process for using a throat pack in orthognathic surgery.

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Current practices and beliefs regarding the use of oropharyngeal throat pack in India

Cited by 7 publications

References 10 publications

The application of an oropharyngeal throat pack in maxillofacial surgeries in Marathwada region

The application of an oropharyngeal throat pack in maxillofacial surgeries in Marathwada region

Survey on the Awareness of the Use of Oropharyngeal Throat Packs in Dental Anesthesia: An International Online Survey

Suggestions on management process of throat pack in orthognathic surgery: a case report and literature review

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