Study of cardiovascular effects of occlusive nasal packing versus minimal packing following nasal surgeries
Journal Title: Medpulse International Journal of ENT - Year 2017, Vol 5, Issue 2
Abstract
This study was performed to compare cardiac effects of completely occlusive nasal packing with minimal packing in patients undergoing nasal surgeries. A total of forty patients were studied. Twenty patients were given a totally occlusive nasal pack and twenty patients had minimal packing. All patients underwent 24 hour holter monitoring and SAECG pre and postoperatively. In holter monitoring there was a significant increase in minimum and maximum heart rates in the patients in group 2 (patients with minimum packing). Heart rate variability studied by spectral analysis showed a significant increase in HF domain in both the groups indicating an increase in parasympathetic stimulation in both the groups. The intergroup difference was statistically not significant. There was a decrease in the LF domain noted in the group 1 but an increase in the same in group 2. This indicates an increase in the sympathetic stimulation in the group 2 which can also explain a greater increase in the minimum and maximum heart rates in group 2. There was no statistical difference between the two groups. There was no arrhythmia noted in either group pre or post operatively. The QRSD and RMS40 studied in SAECG did not show any statistical difference between the two groups. Increased parasympathetic stimulation in both the groups can be explained by the nasocardiac reflex. A greater increase in the minimum and maximum heart rates in group 2 shows possibly lesser magnitude of vagal stimulation in this group due to minimal pressure on the nasal mucosa. No changes in SAECG parameters can be explained by a relatively lesser sympathetic stimulation in both the groups. We concluded that there was no significant difference in cardiac effects between completely occlusive or minimal packing post nasal surgery in a relatively healthy patient group. This needs further evaluation with a larger study in cardiac patients
Authors and Affiliations
Navneeta Gangwar, Nitin Kansal, Krishnananda Nayak, Umesh Pai, Deepak Ranjan Nayak
Keywords
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