Abstract

A common method employed in nasal surgery is the anterior nasal packing. One of the complications debated today is about the cardiovascular effects due to the use of this method. The purpose of this study was to evaluate some cardiac parameters in different groups of patients subjected to septoplasty, to identify the safest way to use nasal packing in postoperative treatment and to minimize its cardiovascular complications. In this clinical trial, 104 candidates for septoplasty were initially screened, of which, 14 patients were excluded and 90 patients were selected by block randomization. Different assessors monitored blood pressure, heart rate and cardiac rhythm three times before surgery. Then a classic septoplasty was performed in all patients, after which patients were randomly divided into three groups: 1) without nasal packing, 2) with nasal packing, and 3) with nasal packing that had an airway. Blood pressure and heart rate were monitored, following surgery, by a 24-hour Holter. The monitoring data were analyzed and interpreted by a cardiologist. The significance criteria of data were assumed as p-values <= 0.05. Mean diastolic blood pressures after surgery in groups 1-3 was: 73.4 +/- 7.3 mmHg, 76.4 +/- 5.8 mmHg and, 80.9 +/- 6 mmHg, respectively, showing lower values in patients without nasal packing and a significant difference in patients that had nasal packing with an airway (p=0.03). Mean heart rates after surgery in groups 1-3 were 71.8 +/- 11.3, 77.7 +/- 7.9 and 79.1 +/- 6.7, respectively, showing a significant difference of the first group with respect to group 3 (p=0.043). This research showed that the use of anterior nasal packing with or without airway leads to cardiovascular changes such as increased diastolic blood pressure and heart rate. More studies should be conducted for a definitive conclusion, so the balance of its risks and benefits must be considered, when using nasal packing after septoplasty surgery.