Influence of bilateral nasal packing on sleep oxygen saturation after general anesthesia: A prospective cohort study

Abstract

ObjectiveThis study aims to evaluate the effect of bilateral nasal packing on sleep oxygen saturation and its influencing factors on the first night after general anesthesia.MethodA total of 36 adult patients who underwent bilateral nasal packing with a nonabsorbable expanding sponge after general anesthesia surgery were prospectively studied. All these patients underwent overnight oximetry tests before and the first night after surgery. The following oximetry variables were collected for analysis: the lowest oxygen saturation (LSAT), the average oxygen saturation (ASAT), the oxygen desaturation index of ≥4% (ODI4), and the percentage of time with oxygen saturation below 90% (CT90).ResultsAmong the 36 patients, the incidences of both sleep hypoxemia and moderate-to-severe sleep hypoxemia increased with bilateral nasal packing after general anesthesia surgery. All the pulse oximetry variables we studied deteriorated significantly after surgery: both LSAT and ASAT decreased significantly (P < 0.05), while both ODI4 and CT90 increased significantly (P < 0.05). In a multiple logistic regression analysis, body mass index (BMI), LSAT, and modified Mallampati grade were found to be independently predictive for a larger decrease in LSAT (≥5%) after surgery (all P’s < 0.05).ConclusionBilateral nasal packing after general anesthesia could induce or aggravate sleep hypoxemia, especially in patients with obesity, relatively normal sleep oxygen saturation, and high modified Mallampati grades.

Effects of Nasal Packing on Patients’ Post-operative Vital Signs

“…We also compared our results with past research in the literature. Guan et al found that bilateral nasal packing could cause sleep hypoxemia, which aligns with the results of our study, and patients with bilateral nasal packing had significantly low SpO2 levels postoperatively [11].…”

“…In our study, 56 (67.5%) patients were male, while 27 (32.5%) of the patients were female. The mean age of the participants was 27.65 years, and these demographics are comparable to previously conducted studies [11][12][13][14][15][16]. The most common surgery for which nasal packing was performed for patients in our study was septoplasty, which matches the findings of other past studies [12,17].…”