Document Detail

The effects on cardiac functions and arterial blood gases of totally occluding nasal packs and nasal packs with airway.
MedLine Citation:
PMID:  20938948     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effects on cardiac functions and blood arterial gases of totally occluding nasal packs and nasal packs with airway.
STUDY DESIGN: Prospective, randomized trial.
METHODS: Thirty-nine adults without any comorbidities underwent septoplasty or septorhinoplasty and had nasal packs placed postoperatively; 19 nasal packs with airways and 20 totally occluding nasal packs. Twenty-four-hour Holter monitorization was done pre- and postoperatively. Arterial blood gas analysis was performed both before the operation and after application of nasal packs.
RESULTS: Application of packs with airway did not cause any significant changes in blood gas parameters. Packing with totally occluding nasal packs caused a significant decrease in HCO(3) and pCO(2), and insignificant changes in pO(2), O(2) saturation, and pH. No serious arrhythmias were observed in any patient. In both groups, nasal packing resulted in a significant increase in minimum heart rates, a significant decrease in maximum heart rates, and insignificant changes in the mean heart rates. Heart rate variability obtained from 24-hour Holter electrocardiography was analyzed by power spectral analysis. An increase in the high-frequency (HF) domain, a decrease in the low-frequency (LF) domain, and a decrease in the LF/HF ratio were observed after packing in both groups.
CONCLUSIONS: Nasal pack-induced cardiac complications may occur due to increased vagal stimuli secondary to nasal mucosa compression rather than obstruction-related hypoxia. The use of nasal packs in the elderly patients with cardiopulmonary disease warrants close observation. Nasals packs with airways should be preferred in patients susceptible to hypoxia.
Ehab Zayyan; Ehab Zeyyan; Münir Demir Bajin; Kudret Aytemir; Taner Yılmaz
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Laryngoscope     Volume:  120     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-29     Completed Date:  2011-01-07     Revised Date:  2011-07-13    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2325-30     Citation Subset:  IM    
Hacettepe University Department of Otorhinolaryngology, Hacettepe University Hospital, Ankara, Turkey.
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MeSH Terms
Anoxia / etiology*,  physiopathology
Arrhythmias, Cardiac / etiology,  physiopathology
Blood Gas Analysis
Electrocardiography, Ambulatory
Follow-Up Studies
Heart Function Tests
Heart Rate / physiology
Middle Aged
Nasal Obstruction / physiopathology
Nasal Septum / surgery*
Oxygen / blood*
Postoperative Care / methods
Postoperative Complications / physiopathology
Prospective Studies
Reference Values
Rhinoplasty / adverse effects*,  methods
Risk Assessment
Tampons, Surgical / adverse effects*
Treatment Outcome
Young Adult
Reg. No./Substance:
Erratum In:
Laryngoscope. 2011 Jun;121(6):1351
Note: Zeyyan, Ehab [corrected to Zayyan, Ehab]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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