Do totally occlusive nasal packs after nasal surgery increase the risk of immediate respiratory distress during recovery from anesthesia?

Kulak Burun Bogaz Ihtis Derg. May-Jun 2016;26(3):159-63. doi: 10.5606/kbbihtisas.2016.04307.


Objectives: This study aims to compare the risk of immediate respiratory distress (IRD) during the recovery of anesthesia between the nasal surgery with totally occlusive nasal packing and non-respiratory tract-related surgeries.

Patients and methods: A total of 300 patients (180 males, 120 females; mean age 30.1±8.2 years; range 18 to 52 years) were included in the study. The patients were assigned to one of two age- and sex-matched groups according to surgery type: 1) patients undergoing nasal surgery with totally occlusive nasal packs for nasal septum deviation or 2) patients undergoing non-respiratory tract surgeries for various diseases. Immediate respiratory distress was defined as any unanticipated hypoxemia, hypoventilation or upper-airway obstruction (stridor or laryngospasm) requiring an active and specific intervention.

Results: The patients who underwent nasal surgery with totally occlusive nasal packs had a 6.25 times higher risk of IRD than the patients who underwent non-respiratory tract surgery during recovery from general anesthesia. Smokers had a 4.8 times higher risk of having IRD than non-smokers during the post-extubation phase. There were no significant differences in the incidence of IRD between males and females.

Conclusion: Based on our study results, totally occlusive nasal packs and smoking were associated with poor extubation status at the end of the surgical procedure.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, General*
  • Dyspnea / etiology*
  • Epistaxis / etiology
  • Epistaxis / prevention & control
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Septum / surgery
  • Nasal Surgical Procedures*
  • Risk
  • Smoking
  • Tampons, Surgical / adverse effects*
  • Young Adult