A Comparison Between Conventional Throat Packs and Pharyngeal Placement of Tampons in Rhinology Surgeries

Study Overview
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Brief Summary
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Post-operative, throat pain, nausea and vomiting is a common occurrence in rhinology surgeries due to the use of throat packs during the procedure. In order to optimize quality of care and patient satisfaction, the aim of this study to evaluate the incidence of post-operative, throat pain, nausea and vomiting in patients that have been packed with either conventional gauze throat packs or pharyngeal tampons.

Detailed Description
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The nose and para nasal sinuses are anatomically known to be highly vascular and a substantial amount of bleeding is expected from rhinology surgeries, ingested blood is known to be a power full emetic, and the risk aspiration of blood is present due to the fact that an endotracheal tube is not 100% effective in protecting the airway. Post-operative nausea and vomiting is a frequent problem that is encountered in surgical patients with a 4th to 6th fold increase in nasal and endoscopic sinus operations. Posterior throat pack is an often-used in rhinology surgery, it is said to help in protecting the air way against aspiration and also helps in the reduction of post-operative nausea and vomiting, however many studies concluded that posterior throat pack is associated with higher amount of post-operative pain, nausea,, vomiting and in some rare cases even forgotten in the patient leading to mortality. However, despite poor evidence the placement of posterior throat packs is commonly practiced by surgeons and anesthetists because the possible risk of aspiration is worrisome to the latter and the former. A conventional throat pack consists of gauze, but an alternative practice involves the pharyngeal placement of tampons. In Marais and Prescott posterior pharyngeal placement of tampons is associated with a decrease amount of post-operative throat pain, when compared to conventional gauze throat packs, however they did not compare the incidence of post-operative nausea and vomiting in both groups.

Official Title
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A Comparison Between Conventional Throat Packs and Pharyngeal Placement of Tampons in Rhinology Surgeries

Conditions
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Pain, Postoperative Pain, Bleeding, Nose Bleed

Intervention / Treatment
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* Other: Throat Pack
* Other: Pharyngeal Tampons


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults patients ( above the age of 18 years) Admitted under Dr. Hiba Al-Reefy Underwent a rhinology procedure that required the use of a throat pack Exclusion Criteria: Pediatric patients Pt who underwent a procedure without the use of throat packs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Control<br>Standard care (Throat pack) which will be used as a control. | Other: Throat Pack<br>* Post rhinology surgery throat packs will be used as a control to compare against the intervention (Pharyngeal tampons)<br>* Other names: Control;|
| Experimental: Intervention<br>Pharyngeal tampons which will be used as a comparator against throat pack. | Other: Pharyngeal Tampons<br>* Post rhinology surgery Pharyngeal Tampons will be used as an intervention to compare against the throat pack (control)<br>* Other names: Intervention;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of postoperative throat pain using the visual analogue scale (VAS) | Evaluation of postoperative pain between pharyngeal tampons and controls using the Visual Analogue scale. A value of 0 is the lowest value and indicates the patient is pain free. And a score of 10 is the maximum value which indicates extreme pain on the scale. | 2 years | 
| postoperative throat bleed | Evaluation of postoperative bleeding in patients using pharyngeal tampons vs control | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative recovery | Assess the postoperative symptom recovery | 2 years |