Soaking oro-pharyngeal pack with triamcinolone acetonide lowers discomfort in functional endoscopic sinus surgeries

Abstract

background: Postoperative sore throat (POST) is defined as pain or discomfort in the throat following general anesthesia. Throat packs are used by many surgical subspecialties for different benifits, however they may increase the incidence of POST. Many interventions can be used to decrease incidence of POST. Triamcinolone acetonide (TA) is a moderately potent topical corticosteroid preparation. In this study, we hypothesized that soaking the throat pack with TA may decrease POST. Methods and Material: This prospective interventional comparative study was performed on 54 patients planned for Functional Endoscopic Sinus Surgeries (FEES) surgery. After endotracheal intubation, a standard length of oro-pharyngeal pack was placed, then patients were randomly allocated into: Group I: Oro-pharyngeal packs were soaked with 15 mg Triamcinolone acetonide 0.1% and Group II: packs were soaked with the same volume of lubricating gel (K-Y gel®). The patients were postoperatively asked about: sore throat, dysphagia, hoarseness of voice and nausea and vomiting. Results: Thirty minutes and 24 hours after extubation, Group I patients showed lower but statistically insignificant sore throat scores. Two to six hours after extubation, Group I showed a statistically significant reduction in sore throat scores. Six patients suffered dysphagia in group I compared with 8 patients in group II. Hoarseness of voice occurred in 1 patient in group I and 3 patients in group II. No patient complained of nausea or vomiting. Conclusión: Soaking oropharyngeal pack with triamcinolone acetonide in orabase gel was able to decrease POST in FESS patients.

Effect of fluticasone-impregnated throat packs on postoperative sore throat (POST) and hoarseness of voice: A randomized clinical trial

“…Smoking is a significant predictor because it is known to cause airway inflammation on its own, 32,33 which contributes to POST, however, due to the small sample size in this study, we were unable to detect any influence on POST, which is similar to the study by Lee et al 34 In the study by Higgins et al, 2 he found that the incidence of POST was higher in those with ASA physical status III when compared to those with ASA I/II (p≤0.05), however in our study all the patients had ASA status of I/II, thus no difference could be recorded. Longer surgery times have been shown in earlier studies 35,36 to affect the occurrence of POST, with factors including surgical manipulation of the airway and surrounding tissue, repeated suctioning, high anesthetic gas flow rates, and lack of airway humidity as contributors. However, in our study, there was no such difference because all of the patients were posted for nasosinus surgery and the surgical times in the two groups were comparable.…”

Interest of pharyngeal packing in head and neck surgery: a meta-analysis

“…-Low methodological quality, with a modified Jadad score of less than 4 (n = 4) [10,[29][30][31]. -Ongoing study with results not yet published (n = 8) [32][33][34][35][36][37][38][39].…”