scholarly journals An evaluation of merocel and neosporin impregnated ribbon gauze packs in patients following nasal surgery: a prospective randomised trial

1970 ◽  
Vol 10 (1) ◽  
pp. 30-34 ◽  
Author(s):  
RR Joshi ◽  
A Nepal ◽  
S Thapa Chhetri ◽  
S Bhandary ◽  
TB Panta ◽  
...  
Keyword(s):  
Pain Score ◽  
Polyvinyl Acetate ◽  
Randomised Trial ◽  
Visual Analog Score ◽  
Patient Comfort ◽  
Nasal Surgery ◽  
Prospective Randomised Trial ◽  
Post Operative Pain ◽  
The Mean

Background: Packs are placed following nasal surgeries to arrest haemorrhage, to prevent septal haematoma and synechie formation. Despite Merocel, a tampon constructed from a foam polymer of hydroxylated polyvinyl acetate, which is less abrasive and hence associated with the less pain, we still use Neosporine Impregnated Ribbon Gauze (NIRG). Objective: To compare Merocel and the Neosporine Impregnated Ribbon gauze (NIRG) packs in regards to the post-operative pain levels caused by them and their ability to prevent haemorrhage, crusting and synechie. Methods: The nose was packed after surgery either with the Merocel pack or Neosporin Impregnated Ribbon Gauze (NIRG) according to the randomisation. The pain score was noted on the Visual analog score while packs were in situ and again immediately after the pack removal. The haemorrhage, crusting and synechie were noted if present. Results: Among 106 patients, 61 were male and 45 were female. In Merocel group there were 51 patients and in NIRG group 55. The mean pain score for merocel was 4.15 while in situ and 3.66 immediately after removal where as mean pain score for NIRG was 6 while in situ and 3.78 immediately after removals. Post-operative crusting and synechie were seen relatively more in NIRG pack group. Conclusion: Merocel is superior in terms of both patient comfort and pain. DOI: http://dx.doi.org/10.3126/hren.v10i1.6004 HREN 2012; 10(1): 30-34

scholarly journals Comparison of Polyvinyl Acetate Sponge and Medicated Ribbon Gauge Nasal Pack following Nasal Surgery

2019 ◽  
Vol 21 (1) ◽  
pp. 31-34
Author(s):  
Shova Maharjan ◽  
AK Jha ◽  
RR Joshi ◽  
AS Rijal ◽  
KK Shrestha ◽  
...  
Keyword(s):  
Pain Score ◽  
Polyvinyl Acetate ◽  
Tertiary Hospital ◽  
Acetate Group ◽  
Nasal Surgery ◽  
Nasal Pack ◽  
Prospective Comparative Study ◽  
Open Mesh ◽  
Made In

 Nasal occlusive dressings are routine after nasal surgeries to arrest hemorrhage, to prevent septal hematoma, and to prevent postoperative adhesions. However, patients describe nasal packing and its removal as their worst experience. Various types of nasal packs are available. Medicated ribbon gauge is the traditional form of nasal pack which consists of an open-mesh cotton as a carrier whereas “Polyvinyl Acetate’ sponge is a compressed dehydrated material, an improvised one which increases in size and compresses blood vessels when rehydrated with normal saline. As Polyvinyl acetate sponge is smooth and spongy, it causes less pain and abrasion while in-situ and removal. This was a prospective comparative study done in tertiary hospital of Nepal. Patients were subjected to either polyvinyl acetate sponge or ribbon gauge nasal pack following nasal surgery. Comparisons were made in terms of pain score, maintenance of hemostasis and wound healing. There were 154 patients in the study with 104 males and 50 females. The pain score when nasal pack was in-situ was similar in both groups whereas it was lesser in the polyvinyl acetate group on its removal. However, bleeding and adhesion were found to be similar. Crust formation was less in polyvinyl acetate group. Six synaechia were noted in ribbon gauge group only. Pain was significantly less during removal of polyvinyl acetate pack.

Minilaparotomy Cholecystectomy as a Day Surgery Procedure: A Prospective Clinical Pilot Study

2007 ◽  
Vol 96 (3) ◽  
pp. 206-208 ◽  
Author(s):  
J. Harju ◽  
M. Pääkkönen ◽  
M. Eskelinen
Keyword(s):  
Randomised Trial ◽  
Operating Time ◽  
Day Surgery ◽  
Prospective Randomised Trial ◽  
Wound Pain ◽  
Average Operating ◽  
Average Operating Time ◽  
Study Support ◽  
The Mean

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as a day surgery procedure. Patients and Methods: Thirty elective symptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27–68), the mean body mass index 29 kg/m2 (range 19–41). Gallstones were confirmed with ultrasound and the pre-operative liver laboratory tests were normal in all patients. A five (+/-2) centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter. Results: The average operating time was 51 minutes (range 30–105 minutes). Day surgery was possible in 25 cases (83%). Five patients (17%) stayed over night at the hospital. There were four (13%) conversions to conventional cholecystectomy. The average postoperative sick leave was 16 days (range 14–30). Two patients returned to hospital. One patient had wound pain, but no complication was found, and the patient was not admitted. One patient had a wound infection and spent 6 days in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients. Conclusions: The results of this study support the suitability of MC as a day surgery procedure, but a prospective randomised trial is needed to evaluate the relative advantages of MC and LC.

Rapid Rhino versus Merocel nasal packs in septal surgery

2011 ◽  
Vol 125 (12) ◽  
pp. 1244-1246 ◽  
Author(s):  
A Hesham ◽  
A Ghali
Keyword(s):  
Standard Deviation ◽  
Pain Score ◽  
Visual Analogue Score ◽  
Nasal Packing ◽  
The Other ◽  
Septal Surgery ◽  
Patient Tolerance ◽  
Operative Complications ◽  
The Mean

AbstractObjective:To compare Rapid Rhino and Merocel packs for nasal packing after septoplasty, in terms of patient tolerance (both with the pack in place and during removal) and post-operative complications.Materials and methods:Thirty patients (aged 18–40 years) scheduled for septoplasty were included. Following surgery, one nasal cavity was packed with Rapid Rhino and the other one with Merocel. Patients were asked to record pain levels on a visual analogue score, on both sides, with the packs in situ and during their removal the next day. After pack removal, bleeding was compared on both sides.Results:The mean ± standard deviation pain score for the Rapid Rhino pack in situ (4.17 ± 1.78) was less than that for the Merocel pack (4.73 ± 2.05), but not significantly so (p = 0.314). The mean pain score for Rapid Rhino pack removal (4.13 ± 1.76) was significantly less that that for Merocel (6.90 ± 1.67; p = 0.001). Bleeding after pack removal was significantly less for the Rapid Rhino sides compared with the Merocel sides (p <0.05).Conclusion:Rapid Rhino nasal packs are less painful and cause less bleeding, compared with Merocel packs, with no side effects. Thus, their use for nasal packing after septal surgery is recommended.

P91 Post-operative pain in neurosurgery

2019 ◽  
Vol 90 (3) ◽  
pp. e46.1-e46
Author(s):  
PM Haigh ◽  
F Al-Hatimi ◽  
H Stewart ◽  
S Rajagopal ◽  
S Khalifa ◽  
...  
Keyword(s):  
Pain Score ◽  
Spinal Surgery ◽  
Foramen Magnum ◽  
P Value ◽  
Inflammatory Agent ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean

ObjectivesAre the analgesic guidelines for those neurosurgical operations associated with major and complex major pain consistently followed? Is there a correlation between adherence and post-operative pain?DesignPatients undergoing spinal surgery and foramen magnum decompressions were visited on the first post-operative day (D1). They provided their pain score subjectively (0=nil; 10=worst ever experienced); objectively we recorded whether they could move in/out of bed without pain limitation.Subjectsn=57 consecutive patients undergoing elective major and complex major pain neurosurgery between April and June 2018 at the NHNN, Queen Square.MethodsA proforma was completed on D1. The patients consented to take part and answered three questions. We examined what (if any) analgesics they were admitted on, and what had been prescribed to cover the post-operative period. This was compared against the appropriate guideline for that category of operation.ResultsGuidelines were only followed in 16/57 (28.1%) cases; not followed in 41/57 (71.9%). On an unpaired T-test: 2-tailed P value=0.0195. Where guidelines were followed, the mean pain score reported was: 3.75 (SD 2.72) Where not followed, the mean pain score was 5.46 (SD 2.29). So with a 95% confidence interval −3.41 to −0.29, there is a significant difference between the pain in those prescribed according to the guidelines and those that were not.ConclusionsThe pain guidelines are not routinely followed. Most commonly this was due to no prescription for a non-steroidal anti-inflammatory agent. We suggest regular sessions of education of the guidelines. Cycle 2 closed the loop of the audit. We re-reviewed adherence and pain scores and found guidelines were followed in 34% of cases, which represented a 6% improvement. On a paired two-tailed P value=0.0794. The mean pain score where guidelines were followed=3.42 (SD1.62) against a mean=4.74 (SD 1.89) where guidelines were not followed.

A comparison of packing materials used in nasal surgery

1994 ◽  
Vol 108 (7) ◽  
pp. 564-566 ◽  
Author(s):  
R. J. N. Garth ◽  
A. P. Brightwell
Keyword(s):  
Prospective Study ◽  
Patient Comfort ◽  
Nasal Surgery ◽  
Packing Materials ◽  
Significant Difference ◽  
Materials Used ◽  
A Prospective Study

AbstractA prospective study was performed to compare Telfa,® paraffin gauze, Merocel® and BIPP used postoperatively following septal or turbinate surgery. Packs were assessed in terms of patient comfort, control of bleeding and ease of removal. There was little to choose between the packs while they were in situ and there was no significant difference in ease of removal. On removal the Telfa® and paraffin gauze were associated with less discomfort and less bleeding than BIPP or Merocel® (p<0.05).

scholarly journals Ultrasonic cutting and coagulation device versus conventional diathermy dissection in thyroid surgery: prospective randomized trial

2018 ◽  
Vol 4 (2) ◽  
pp. 335
Author(s):  
Aditya Singhal ◽  
Dharma Kant Baskota ◽  
Kunjan Acharya
Keyword(s):  
Pain Score ◽  
Thyroid Surgery ◽  
Operative Time ◽  
Ultrasonic Device ◽  
Post Operative Pain ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Lottery System ◽  
Ultrasonic Cutting

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The objective of this study was to compare the operative time and postoperative outcomes in thyroid surgeries using the ultrasonic cutting and coagulation device with conventional diathermy dissection. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was a prospective, interventional, cohort study. The patients   were randomized in two groups by lottery system. The patients operated with ultrasonic device were labeled as Group A: UCCD and by conventional diathermy as Group B: CDD. The operative time, postoperative drain volume, pain score on VAS and complications were assessed and compared in between the two techniques of surgery.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Total of 18 males and 58 females underwent thyroid surgery with age ranging from 17 to 75 years. The operative time in UCCD group was less than CDD group (93.29 min vs. 106.59 min; p=0.06). The cumulative mean amount of drain was found to be less in UCCD group, this difference was statistically significant (77.86 ml vs. 138.05 ml; p=0.00018). The drain was removed earlier in UCCD group, this comparison was also statistically significant (2.49 days in UCCD group vs. 3.02 days in CDD group; p=0.000009). The mean pain score was found to be statistically significant on all the postoperative days in UCCD group. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The patients experienced less pain and complication while using UCCD as technique for surgery.  Hence, ultrasonic device using both cutting and coagulating mode at the same time is efficient in hemostasis and lesser post-operative pain, and found to be advantageous.</span></p>

scholarly journals A comparative study of adenoidectomy by microdebrider vs conventional method

2018 ◽  
Vol 4 (3) ◽  
pp. 808
Author(s):  
M. Muniraju ◽  
Mohammed Saifulla
Keyword(s):  
Pain Score ◽  
Recovery Time ◽  
Operative Time ◽  
Recovery Period ◽  
Collateral Damage ◽  
Adenoid Tissue ◽  
Post Operative Pain ◽  
Group A ◽  
The Mean ◽  
Group B

<p class="abstract"><strong>Background:</strong> Adenoidectomy is a commonly performed ENT surgery. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative for conventional curettage method.</p><p class="abstract"><strong>Methods:</strong> Sixty consecutive cases requiring adenoidectomy were randomized into two groups of thirty each. Group A underwent endoscopic assisted micro-debrider adenoidectomy and Group B underwent conventional adenoidectomy using the curettage method in study period from November 2015 to May 2017.  </p><p class="abstract"><strong>Results:</strong> The average time taken in Group A was 34.10 minutes and in Group B was 22.83 minutes (p&lt;0.001). The average blood loss in Group A was 29.57 ml as compared to 16.67 ml in Group B (p&lt;0.001). The resection was invariably complete in Group A whereas five (16.7%) cases had more than 50% residual adenoid tissue in Group B. Four cases in group B had collateral damage whereas in Group A, there were no added injuries. Post operative pain was studied only in cases undergoing adenoidectomy alone. Group A (n=8) demonstrated a pain score of 3.50 – 3.09 whereas Group B (n=11) demonstrated a pain score of 2.75-2.55. In group A, the mean recovery period was 2.80 days and 8.23 days in Group B (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic powered adenoidectomy was found to be a safe and effective tool for adenoidectomy. The study parameters where endoscopic powered adenoidectomy fared better were completeness of resection, accurate resection under vision, lesser collateral damage and faster recovery time. On the other hand, conventional adenoidectomy scored in matter of lesser operative time and intra-operative bleeding.</p>

Nerve Blocks Prior to Microfocused Ultrasound Treatment are Safe and Reduce Patient Discomfort

2020 ◽  
Vol 40 (8) ◽  
pp. 887-891
Author(s):  
Marc A Polacco ◽  
Daniel R Butz ◽  
Rachel Bass ◽  
Teresa Luu ◽  
Esra Kurum ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pain Score ◽  
Ultrasound Treatment ◽  
Patient Comfort ◽  
Control Group ◽  
Level Of Evidence ◽  
Nerve Blocks ◽  
Patient Discomfort ◽  
The Mean ◽  
Split Face

Abstract Background Microfocused ultrasound with visualization has become one of the more popular nonsurgical facial rejuvenation therapies available. Although the treatment has gained wide acceptance, providing adequate pain relief during the procedure can be challenging. Objectives The aim of this study was to test our hypothesis that nerve blocks prior to treatment would be well tolerated and significantly reduce patient discomfort. Methods Subjects undergoing microfocused ultrasound were offered the choice of participating in a split face nerve block, bilateral block, or a control group. Nerves targeted included infraorbital, supratrochlear, supraorbital, zygomaticofrontal, mental, great auricular, and cervical plexus. Pain assessment was based on a 10-point Wong-Backer FACES Pain score. Results A total of 65 patients were included in the study: 28 in the split face group, 19 in the bilateral block group, and 18 without a block. The mean [standard deviation] pain score of the bilateral block cohort was 3.9 [1.2], and that of the control group was 5.1 [1.7] (P = 0.001). Patients in the split face cohort reported a higher pain score on the unblocked side of the face (7.5 [1.3]) than on the blocked side (2.9 [1.0]) (P &lt; 0.001). The mean pain score for local anesthetic injection was 2.7 and 1.4 for the split face and the bilateral groups, respectively. There were no adverse events. Conclusions Nerve blocks are well tolerated and significantly improve patient comfort during microfocused ultrasound treatment without compromising outcomes or increasing adverse events. Level of Evidence: 2

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