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A prospective double-blind randomized controlled trial of the effect of topical bupivacaine on post-operative pain in bilateral nasal surgery with bilateral nasal packs inserted

Published online by Cambridge University Press:  08 March 2006

Malcolm A Buchanan
Affiliation:
Department of Otorhinolaryngology, Western General Hospital, Edinburgh, UK.
Graham R Dunn
Affiliation:
Department of Otorhinolaryngology, Western General Hospital, Edinburgh, UK.
Gillian M MacDougall
Affiliation:
Department of Otorhinolaryngology, Western General Hospital, Edinburgh, UK.

Abstract

To ascertain whether local anaesthetic use is of clinical benefit in nasal surgery, a prospective double-blind randomized controlled trial of topical bupivacaine on post-operative pain in patients packed after bilateral nasal surgery was carried out. Each patient received a bupivacaine-soaked and a saline-soaked Merocel pack, thereby acting as their own control. Power analysis ascertained the number of patients required to enter the trial to detect a statistically significant difference in pain. Fifty-seven patients completed the trial. Visual analogue scales determined the level of post-operative pain at different time points in each nostril. Less pain was demonstrated in nostrils containing bupivacaine-soaked packs compared with saline-soaked packs at two hours (p < 0.0001), four hours (p = 0.0183) and six hours (p = 0.0476) post-operatively. Although not statistically significant, less pain was noted on pack removal on the local anaesthetic sides. These results provide clinical-based evidence for the use of bupivacaine as a local anaesthetic in reducing pain following nasal surgery with packing.

Type
Research Article
Copyright
© 2005 Royal Society of Medicine Press

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