Can Pharyngeal Packing Prevent Postoperative Nausea and Vomiting in Nasal Surgery?

Abstract

Objectives: We aimed to perform a meta-analysis for the efficacy of pharyngeal packing during nasal surgery in the prevention of postoperative nausea and vomiting (PONV).

Data sources: MEDLINE, SCOPUS, and the Cochrane database.

Methods: Two authors independently searched the databases for relevant studies from inception to October 2017. Included studies were randomized controlled studies published in English comparing pharyngeal packing during intubation (packing group) with no packing (control group) in patients who underwent nasal surgery. Outcomes of interest included the incidence of PONV and throat pain during the first 24 hours postsurgery.

Results: Ten studies were included in the meta-analysis. The incidence of moderate-to-severe PONV in the recovery room was significantly higher in the packing group than in the control group. However, the incidence of moderate-to-severe PONV significantly decreased and was lower in the packing group than in the control group at 2 hours postoperative. The incidence of throat pain was higher in the packing group than in the control group until 2 hours postoperative.

Conclusions: Considering the occurrence of postoperative morbidity according to the time course, pharyngeal packing during nasal surgery does not alleviate PONV but instead could aggravate postoperative throat pain. Additionally, pharyngeal packing has the possibility of airway problem such as the foreign body aspiration. Based on our results, we suggest that there is no need to place a pharyngeal pack to prevent PONV in patients undergoing nasal surgery.

Level of evidence: 1b Laryngoscope, 129:291-298, 2019.

Keywords: Pharyngeal packing; nasal packing; postoperative nausea and vomiting.