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Effect of prilocaine and its combination with tramadol on anxiety and pain during nasal packing removal

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the effect of local usage of prilocaine and ıts combination with tramadol on the pain and anxiety levels of patients during nasal packing removal.

Methods

A total of 117 patients who were treated with the Merocel nasal packing after septoplasty were included in the study. Patients whose Merocel nasal packings infiltrated with prilocaine (P group), prilocaine combined with tramadol 1 mg/kg (P + T1 group), prilocaine combined with tramadol 2 mg/kg (P + T2 group), or normal saline solution (Control group) before nasal packing removal were compared for their pain, sedation, and anxiety related to this removal procedure. The visual analog scale (VAS), Ramsay sedation scale (RSS), and State–Trait Anxiety Inventory (STAI) scale were assessed to evaluate the pain, sedation, and anxiety levels of the patients.

Results

Groups were found similar according to sex, age, and preoperative STAI scores. The VAS score was significantly lower in P, P + T1, and P + T2 than control group during nasal packing removal (p < 0.001, p < 0.001, and p < 0.001, respectively). However, state anxiety inventory (STAI-S) and RSS were found significantly improved only in P + T1 and P + T2 (STAI-S: p = 0.032, RSS: p = 0.002, STAI-S: p = 0.000, RSS: p < 0.001, respectively). In the comparison of P + T1 and P + T2, no significant difference was found in VAS, RSS, and STAI-S (p = 0.604, p = 0.154, and p = 0.264, respectively).

Conclusion

The combined infiltration of prilocaine and tramadol 1 mg/kg into the nasal packing is effective in reducing the pain and anxiety of patients during nasal packing removal

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Funding

This study did not receive funding.

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Authors and Affiliations

  1. Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balıkesir University Health Practice and Research Hospital, Cagis, 10440, Balikesir, Turkey

    Kamil Gokce Tulaci, Erhan Arslan & Hasmet Yazici

  2. Department of Psychiatry, Faculty of Medicine, Balikesir University, Balikesir, Turkey

    Rıza Gokcer Tulaci

Authors
  1. Kamil Gokce Tulaci
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  2. Erhan Arslan
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  3. Rıza Gokcer Tulaci
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  4. Hasmet Yazici
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by KGT, EA, RGT, and HY. The first draft of the manuscript was written by KGT and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kamil Gokce Tulaci.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Balikesir University Faculty of Medicine Ethics Committee (Ethical committee approval number: 2019/71) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tulaci, K.G., Arslan, E., Tulaci, R.G. et al. Effect of prilocaine and its combination with tramadol on anxiety and pain during nasal packing removal. Eur Arch Otorhinolaryngol 277, 1385–1390 (2020). https://doi.org/10.1007/s00405-020-05863-6

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  • DOI: https://doi.org/10.1007/s00405-020-05863-6

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