Comparison of Nasal Packing versus Septal Stitich on Airway Complications during Recovery from Anesthesia

Objective: To compare the incidence of airway related complications associated with nasal packing versus septal stitch in the post-operative period in patients presenting for elective septoplasty for deviated nasal septum (DNS). Study Design: Randomized controlled trial (Iranian registery of Clinical trials: 75068) Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2023. Methodology: Septoplasty was done under general anesthesia in both groups and before extubation, Group-N (n=110) received bilateral Vaseline soaked nasal packing and Group-S received quilted septal sutures (n=110). Primary variables studied were mean time from recovery room to discharge, mean dose of analgesia used post-procedure and pre-discharge, incidence of laryngospasm, hypoxia, bleeding, and headache in 6 hours in the immediate post-operative period in the pre-anesthesia care unit or in the ward. Results: Mean time from recovery to discharge being 19.19±2.24 hours in Group-N versus 12.32±1.36 hours in Group-S (p<0.001). Median pain scores post-procedure once fully awake from anesthesia were 6.00 (1.00) in Group-N and 4.00 (1.00) in Group-S on the Visual Analog Scale (p<0.001). Mean dose of analgesia required for pain from shifting to recovery to discharge was 3.43±0.58 grams in Group-N versus 2.14±0.53 grams in Group-S (p<0.001). Conclusion: We conclude that quilted septal stitch provides better pain scores, patient comfort and less incidence of respiratory complications post-septoplasty.