The effect of nasal packing and suture technique on systemic oxygen saturation and patient comfort after septoplasty

Yıl 2007, Cilt: 17 Sayı: 6, 318 - 323, 24.11.2007

Mustafa Kazkayası Can Dinçer Osman Kürşat Arıkan Rahmi Kılıç

Öz

Objectives: We investigated the effect of intranasal packing placed after septoplasty or alternatively sutur- ing the septum vvithout inserting a packing on systemic oxygen saturation and patient comfort.Patients and Methods: The study involved 37 patients who undervvent septoplasty for isolated septum deviation.İntranasal packing was used in 18 patients 5 women, 13 men; mean age 30±10 years; range 18 to 47 years , while 19 patients 5 women, 14 men; mean age 31±12 years; range 18 to 54 years undervvent nasal septal suturing.To evaluate systemic oxygen saturations, partial oxygen saturations were measured pre- and postoperatively by pulse oximetry. The effect of intranasal packing and sutur­ ing on patient comfort was assessed by a visual analog scale before and 48 hours after surgery, five days after removal of nasal packing, and 30 days after surgery.Results: Postoperative systemic oxygen saturations exhibited higher levels in the sutured group, but this did not reach significance p>0.05 . The incidence of nasal obstruction was significantly higher with nasal packing p<0.05 . İn general, headache and facial pain were more common with nasal packing, while suturing was associ- ated with a higher frequency of nasal crusting, postnasal discharge, and reduced sense of smell p>0.05 .Conclusion: Considering that, albeit not significantly, intranasal packing used after septoplasty decreases systemic oxygen saturation more than suturing and thus, has more adverse effects on patient comfort, suturing the septum may be a better alternative, particularly in elderly patients with chronic systemic diseases.

Anahtar Kelimeler

Blood gas monitoring, nasal septum/surgery, oximetry, surgical sponges, suture technigues

Septoplasti sonrası nazal tampon veya dikiş tekniğinin sistemik oksijen satürasyonu ve hasta konforu üzerine etkisi

Öz

Amaç: Septoplasti sonrası konulan intranazal tampon veya tampon konulmaksızın sadece septuma dikiş atılmasının, sistemik oksijen satürasyonu ve hasta konforu üzerine olan etkileri araştırıldı.Hastalar ve Yöntemler: Çalışmaya, izole septum deviyasyonu tanısıyla septoplasti ameliyatı yapılan 37 hasta alındı. On sekiz hastaya intranazal tampon konulurken, 19 hastada septuma dikiş atıldı. Sistemik oksijen satürasyonunu değerlendirmek için, ameliyat öncesi ve sonrası dönemlerde puls oksimetri cihazı ile parsiyel oksijen satürasyonu ölçüldü. İki yöntemin hasta konforuna etkisi, ameliyattan önce, 48 saat sonra, tampon alındıktan beş gün sonra ve ameliyattan 30 gün sonra görsel analog skala ile değerlendirildi.Bulgular: İstatistiksel olarak anlamlı olmasa da, sistemik oksijen satürasyonu dikiş grubunda tampon grubuna göre daha yüksek bulundu p>0.05 . Tampon grubunda anlamlı derecede daha fazla burun tıkanıklığı izlendi p0.05 .Sonuç: Septoplasti ameliyatı sonrası kullanılan intranazal tamponun sistemik oksijen satürasyonunu anlamlı derecede olmasa da, dikiş kullanımından daha fazla düşürmesi ve hasta konforunu olumsuz etkilemesi nedeniyle, özellikle kronik sistemik rahatsızlıkları olan yaşlı hastalarda septuma dikiş atılması daha uygun olabilir

Anahtar Kelimeler

Kan gazı ölçümü, nazal septum/cerrahi, oksimetri, cerrahi tampon, dikiş tekniği

Kaynakça

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