Effects of glove finger- versus lidocaine-soaked nasal packing after endoscopic nasal surgery: a prospective randomized controlled trial

Purpose: Nasal packing is a common but unpleasant procedure in patients who undergo endoscopic sinus surgery (ESS). The aim of this study was to assess whether a glove-finger pack strategy would reduce pain compared to lidocaine-soaked packs after ESS. Methods: A prospective randomized controlled trial enrolling 120 consecutive patients affected by chronic rhinosinusitis, who underwent bilateral ESS. At the end of surgery 62 subjects received 10 cm non-absorbable pack soaked with 5 mL of 2%-lidocaine solution and 58 received a 10 cm non-absorbable pack coated with a latex free glove finger soaked with saline solution. Data concerning pain were collected using a 0 to 10 visual analogue scale at post-operative hours 1, 4, 8, and 16 and at pack removal (24 h ± 15 min). All post-operative analgesic rescue doses were registered. Also, bleeding was reported. Results: The mean VAS score during pack-removal was significantly lower in glove-finger group than in the lidocaine group (3.22 ± 2.16 vs 4.89 ± 2.90, p = 0.0012). There was no statistically significant difference between re-soaking lidocaine-soaked-packs with saline solution or lidocaine at pack removal time (p = 0.42). Conclusion: Glove-finger nasal pack seems to provide better pain control after ESS, when compared with lidocaine-soaked pack, especially at pack removal time.