TO COMPARE EFFICACY & DISCOMFORT IN POSTERIOR NASAL PACKING WITH FOLEY'S CATHETERS VERSUS BIPP GAUZE PACKING IN CASES OF POSTERIOR EPISTAXIS

Packing in Posterior Epistaxis

Abstract

Objective: To compare efficacy and discomfort in posterior nasal packing with Foley's catheters versus BIPP gauze packing in cases of posterior epistaxis.

Study Design: Randomized controlled trial.

Place and Duration of Study:  Combined Military Hospital (CMH) Kharian from October 2011 to October 2013.

Material and Methods: A total of 206 patients of posterior epistaxis were included in the study through non-probability convenience sampling and randomly divided in two groups of 103 each.  In group A patients were treated by posterior nasal packing with Foley's catheter and in group B patients were treated by posterior nasal packing with BIPP gauze and results in terms of control of epistaxis and discomfort during pack insertion, while the packs were in situ and pack removal, based on VAS (Visual Analogue Scale) were observed.

Results: Average age in group A was 52.64 years (SD=9.57) and in group B it was 50.27 years (SD ± 10.13). There were 71 (68.9%) males in group A while 67 (65%) males in group B. During posterior nasal pack insertion, the mean pain score in Group A was 6.21 (SD ± I.13) and in Group B was 7.43 (SD ± 1.19). The mean pain score with the pack in situ was 4.27 (SD ± 0.08) in Group A versus 4.76 (SD ± 0.09) Group B. Similarly pack removal was also more painful in group B than group A (6.14 ± 0.91 vs 6.89 ± 1.09) (p =0.000). In the group A, 31 (30.1%) patients had rebleeding after pack removal, out of which 9 (8.7%) had significant bleeding requiring repacking. In 22 (21.4%) cases there was mild bleeding which settled without repacking. In group B 22 (21.4%) patients had rebleeding after pack removal, out of which 5 (4.7%) had significant bleeding requiring repacking.

Conclusion: It is concluded that posterior nasal packing with BIPP gauze pack is effective for controlling posterior epistaxis but causes more discomfort to the patients as compared to Foley's catheter packing.