A randomised controlled trial comparing rapid rhino with netcell packs after routine nasal surgery

Abstract

Objectives. To determine whether there is a difference in discomfort between Netcell and Rapid Rhino (RR) packs following routine nasal surgery. Methods. LREC approval for the study was granted. Patients aged 16‐‐65 undergoing septal and inferior turbinate surgery, who did not meet the exclusion criteria, were approached for consent to participate in the trial. Post‐operatively, one nasal cavity was packed with Netcell, and the other with Rapid Rhino (a methodological design used by Arya et al.1). The type of pack inserted on the left side was decided using sequentially numbered opaque envelopes, which were block‐randomised in groups of 4 and 8. By default, the pack used for the right nasal cavity was the other type. Nursing staff removed the packs at 7 am the following day. Prior to and immediately following removal, patients recorded their pain scores for each side on a standard 100 mm visual analogue scale. The left pack was always removed first. A power calculation ensured that enough patients were recruited to provide 90% power for a difference in VAS of 10 mm with a se of 20 mm at the 5% significance level. Results. Primary outcome: RR was significantly more painful on removal than netcell (difference = 10.6 mm, P < 0.001, Wilcoxon signed ranks test). Secondary outcome: There was no significant difference in mean VAS for the packs in situ. One Netcell pack was removed due to bleeding, and replaced with Merocel. Conclusion. The packs are equally comfortable in situ, and RR is more painful on removal. Reference 1 Arya A.K., Butt O. & Nigam A. (2003) Double‐blind randomised controlled trial comparing Merocel with rapid rhino nasal packs after routine nasal surgery. Rhinology41, 241‐‐243