Comparing Cardiac Complications of Bilateral Nasal Packing versus Bilateral packing with Airway after Septoplasty; a Randomized Clinical Trial

Introduction: Anterior nasal packing is a common method in nasal surgery. One of the complications that is debated today is about
cardiovascular effects due to using nasal packing. Objective: This study aimed to evaluate some cardiac parameters in different groups to
identify the safest way and use it in treatment to minimize cardiovascular complications. Method: In this clinical trial, 104 candidates for
septoplasty were initially screened and 14 patients were excluded and 90 patients selected by block randomization. Blood pressure, heart
rate and cardiac rhythm were monitored by different assessor for three time before surgery, then a classic septoplasty was done for all
patients and after it patients were randomly divided into three groups: 1.without nasal packing2.with nasal packing.3.with nasal packing
that had airway. Then, 24 hours after surgery, blood pressure and heart rate were monitored by 24-hour Holter. The monitoring results
were interpreted by a cardiologist and the data were analyzed .Significance criterion of data was assumed as p-value ≤0.05. Results :
Mean diastolic blood pressure after surgery in group 1-3was: 73.4±7.3 mmHg, 76.4±5.8 mmHg, 80.9±6 mmHg respectively and this
criterion was lower in patients without nasal packing and showed a significant difference with patients that had nasal packing with
airway (p=0.03). Mean heart rate after surgery in group 1-3was 71.8±11.3, 77.7±7.9, 79.1±6.7 respectively and the first group showed a
significant difference with group(3) (p=0.043). Conclusion: This research showed that the use of anterior nasal packing with and without
airway leads to cardiovascular changes such as increased diastolic blood pressure and heart rate. More studies should be cond ucted to
create certain conclusion, so it is better that the use of nasal packing be considered on the balance of its risk and benefit.