The effects on cardiac functions and arterial blood gases of totally occluding nasal packs and nasal packs with airway

✍ Scribed by Ehab Zeyyan; Münir Demir Bajin; Kudret Aytemir; Taner Yılmaz

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 96 KB
• Volume: 120
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.21064

✦ Synopsis

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.