The Effect of Prilocaine or Levobupivacaine Infiltration on Pain during Nasal Packing Removal

Abstract

Objective. The aim of this study was to evaluate the efficacy of rehydration of Merocel nasal packs with prilocaine or levobupivacaine on reducing pain and discomfort of nasal packing removal in patients who had undergone septoplasties or endoscopic sinus surgery. Study Design. Prospective clinical study. Setting. Tertiary referral center. Methods. This prospective study was conducted on 72 patients, aged 18 to 55 years, who had undergone septoplasty, bilateral functional endoscopic sinus surgery, or both. The patients were divided into 2 groups: prilocaine group (group P, n = 36), who received 2.5 mL of 2% prilocaine, and levobupivacaine group (group L, n = 36), who received 2.5 mL of levobupivacaine hydrochloride dilution. These solutions were diluted with 2.5 mL saline to a final volume of 5 mL, which was then injected into the Merocel packing 15 minutes before removal of the pack. In both groups, 5 mL of saline was injected into the packing in the contralateral nostril as a control 15 minutes before removal of the pack. Visual analog score (VAS) and the Ramsay sedation score were recorded. Results. Statistically significant differences were found in VAS and Ramsay sedation scale scores of levobupivacaine and prilocaine groups compared to controls. No significant difference was noted between the groups in terms of levobupivacaine and prilocaine. Conclusions. Levobupivacaine or prilocaine infiltration before removal of nasal packs in patients who undergo septoplasties or endoscopic sinus surgery can decrease discomfort and improve patient tolerability.