Study on Pharyngeal Packs in Orthognathic Surgery

Researchers have observed that pharyngeal packs soaked with a combination of chlorhexidine gluconate 0.2% and benzydamine hydrochloride 0.15% (CGBH) improve patient comfort in patients undergoing orthognathic surgery.

The study is published in the Journal of Cranio-maxillo-facial Surgery.

Pharyngeal packing is believed to reduce postoperative nausea and vomiting (PONV) frequency, but has the disadvantage of causing throat pain. Hence, Çağıl Vural and colleagues from the Ankara University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Division of Anesthesiology, Ankara, Turkey conducted this study to investigate whether applying pharyngeal packs soaked with a combination of chlorhexidine gluconate 0.2% and benzydamine hydrochloride 0.15% (CGBH) were effective in preventing postoperative throat pain and PONV in patients undergoing orthognathic surgery.

The authors included a total of 101 patients scheduled for orthognathic surgery in this prospective, double-blind, randomized study. Patients were randomly allocated into two groups: those with CGBH-soaked packing, and those with saline-soaked pharyngeal packing. PONV was recorded using a 5-point Likert scale (0: no PONV to 4: severe PONV) immediately after the surgery at 5, 10, and 30 min, and at 2, 4, 6, 12, and 24 h postoperatively. The severity of throat pain was assessed via two methods: visual analogue scale (VAS, 0: no pain, 10: severe pain) and 6-point Likert scale (0: no pain, 5: strongly severe pain) score at 2, 4, 6, 12, and 24 h postoperatively.

Key Findings

• Mean VAS scores of throat pain were significantly lower in patients receiving CGBH-soaked pharyngeal packs compared to patients receiving saline-soaked pharyngeal packs, at all measured time points.
• There was a tendency towards less PONV in patients receiving a CGBH-soaked pharyngeal pack compared to those receiving a saline-soaked pharyngeal pack; however, this difference did not reach statistical significance.

Hence, they concluded by suggesting that "the usage of CGBH-soaked pharyngeal packs reduce postoperative throat pain in patients undergoing orthognathic surgery. Our results support the implementation of CGBH-soaked pharyngeal packing in orthognathic surgery practice, as a measure to improve patient comfort."