Abstract
The aims of this study were to identify differences in post-operative nausea and vomiting (PONV) and throat pain between throat packed and non-packed patient groups in nasal surgery. This was a prospective, double blind, randomised controlled trial. A water-soaked throat pack gauze was inserted in the mouth to occlude the oropharynx was used in the throat pack group. The second group received no throat pack. A validated PONV questionnaire was completed 6 h post-operatively. Visual analogue scores (VAS) for throat pain were completed in recovery, 2, and 6 h post-operatively. 80 patients were enrolled (40 into each group based on power calculation). With regard to the primary outcome measure, mean PONV score for the throat pack group was 2.75 [median 0, standard deviation (SD 10.86)] and the mean PONV score for the non-packed group was 0.36 (median 0, SD 1.39). The difference in PONV was not statistically significant [P value 0.375, 95% confidence interval (CI) −1.19 to 3.32]. With regard to throat pain VAS scores (our secondary outcome measure), in recovery, the mean throat pain VAS score for the throat packed group was 2.5 (median 1, SD 2.8) and the mean throat pain VAS score for the non-throat packed group was 1.3 (median 0, SD 2.5). Statistical analysis showed a significant difference between the two groups with the throat pack group experiencing more throat pain in recovery (P value 0.018 (95% CI 1.13–2.52). At 2 and 6 h post-operatively, the mean throat pain VAS scores for the throat packed group were 2.1 and 2.3, respectively, and the mean throat pain VAS score for the non-throat packed group was 2.3 and 1.4, respectively. Statistical analysis showed non-significant difference between the two groups at 2 and 6 h post-operatively. The use of throat packs in nasal surgery does not confer PONV reduction benefit. The use of throat pack, however, is associated with a small but statistically significant more throat pain in the initial recovery period from nasal operations.
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Acknowledgements
The authors would like to thank Dr. Suresh Yadlapalli and Dr. Naail Alzuhir for their help with the study design and statistical analysis, respectively.
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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation [Cambridgeshire 3 research ethics committee (REC) and also the Peterborough City Hospital Research and Development department (R&D)] and with the Helsinki Declaration of 1975, as revised in 2008.
Appendix 1: PONV questionnaire
Appendix 1: PONV questionnaire
As adopted from the study by Wengritzky et al. [8]. 
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Al-lami, A., Amonoo-Kuofi, K., Kulloo, P. et al. A study evaluating the effects of throat packs during nasal surgery: a randomised controlled trial. Eur Arch Otorhinolaryngol 274, 3109–3114 (2017). https://doi.org/10.1007/s00405-017-4589-5
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DOI: https://doi.org/10.1007/s00405-017-4589-5