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Effects of Bupivacaine Versus Bupivacaine Plus Dexamethasone-Soaked Nasal Packing After Endoscopic Nasal Surgery

Yayik, Ahmet Murat, MD*; Yildirim, Hasan, MD; Ahiskalioglu, Ali, MD; Sakat, Muhammed Sedat, MD; Ergüney, Özlem Dilara, MD; Ahiskalioglu, Elif Oral, MD*; Sulak, Muhammet Mustafa, MD; Celik, Erkan Cem, MD*

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1174–1177
doi: 10.1097/SCS.0000000000005227
Clinical Studies

Background: The aim of this randomized prospective study was to investigate the postoperative analgesic effectiveness of bupivacaine versus bupivacaine plus dexamethasone-soaked nasal packing in patients scheduled for endoscopic nasal surgery.

Methods: Sixty American Society of Anesthesiologists groups I and II patients aged 18 to 65 years and scheduled for endoscopic nasal surgery were assigned into 2 groups. Group B received 8 mL 0.5% bupivacaine and 2 mL saline, and group BD received 8 mL 0.5% bupivacaine and 8 mg (2 mL) dexamethasone-soaked nasal packing. In the postoperative period, 1000 mg paracetamol was administered and repeated every 6 hours. Postoperative pain scores, additional analgesia requirements and nausea-vomiting were recorded.

Results: Postoperative pain scores were significantly lower in group BD than in group B at 1, 2, 4, 8, and 12 hours, and during tampon removal (P < 0.05), but there was no difference between the groups’ 24-hour visual analog scale scores (P = 0.115). Postoperative additional analgesia use was statistically significantly higher in group B than in group BD (25/30 versus 13/30 respectively, P = 0.001). Postoperative nausea and vomiting was statistically higher in group B than in group BD (11/30 versus 4/30 respectively, P = 0.037).

Conclusion: The addition of dexamethasone to bupivacaine via soaked nasal packing in endoscopic nasal surgery reduced postoperative pain scores, additional analgesia requirements, and PONV. The authors recommended a combination of bupivacaine plus dexamethasone-soaked nasal packing after endoscopic nasal surgery.

*Department of Anesthesiology, Regional Training and Research Hospital

Department of Otorhinolaryngology

Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.

Address correspondence and reprint requests to Ahmet Murat Yayik, MD, Anesthetist, Department of Anesthesiology and Reanimation, Regional Training and Research Hospital, Palandöken, Erzurum 25100, Turkey; E-mail:

Received 10 July, 2018

Accepted 18 November, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.