Arch Plast Surg.  2020 Jan;47(1):15-19. 10.5999/aps.2019.00913.

Effect of lidocaine on pain caused by nasal pack removal after closed reduction of nasal bone fractures

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
  • 2Gangnam Dr. Woo Plastic Surgery Clinic, Gimhae, Korea

Abstract

Background
Pain caused by nasal pack removal after closed reduction of nasal bone fractures is a common problem. This study investigated the effect of infiltrating lidocaine into nasal packs on the pain caused by pack removal after closed reduction of nasal bone fractures.
Methods
Seventy-five patients who underwent closed reduction of nasal bone fractures between March 2016 and March 2018 were enrolled in this prospective, randomized, single-blind study. Merocel (hydroxylated polyvinyl acetate) packs were applied bilaterally and retained for 5 days. Twenty minutes before removal, both packs were rehydrated with 6 mL of 2% lidocaine in 26 patients and with 6 mL of saline in 24 patients; the packs were not rehydrated in 25 patients. Visual analog scale (VAS) scores for pain on removal were recorded.
Results
The mean VAS score was 5.3±2.0 in all patients, 3.8±1.5 in the lidocaine group, 5.8±1.4 in the saline group, and 6.3±2.1 in the non-rehydrated group. There was a significant difference in the pain score between the lidocaine and saline groups (P<0.001) but not between the saline and non-rehydrated groups (P=0.186).
Conclusions
Infiltration of lidocaine into Merocel packs reduced the pain caused by pack removal after closed reduction of nasal bone fractures.

Keyword

Analgesic; Lidocaine; Nasal surgical procedures; Nasal bone
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