Effect of chlorhexidine/benzydamine soaked pharyngeal packing on throat pain and postoperative nausea & vomiting in orthognathic surgery.

Pharyngeal packing is believed to reduce postoperative nausea and vomiting (PONV) frequency, but has the disadvantage of causing throat pain. The present study aimed 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. A total of 101 patients scheduled for orthognathic surgery were enrolled 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. 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. The results of this study suggest 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.

Effect of Verbal and Written Information and Previous Surgical Experience on Anxiety During Third Molar Extraction.

PURPOSE: Third molar extraction is a quite common surgical procedure that causes dental anxiety. This procedure affects patients physiologically and mentally. The type of information provided to patients is important to determine the level of their anxiety regarding the surgical procedure. Patients' experience is also a major determinant of dental anxiety. It is subjective and perceived only by the patient. Questionnaires are tools used to determine and assess patient anxiety. The present study evaluated the effect of verbal and written information and the previous surgical experience of patients on their anxiety before and after third molar extraction. PATIENTS AND METHODS: A total of 66 patients who had been admitted for third molar extraction under local anesthesia were included. The patients were divided into 3 groups: group 1 was given verbal information, group 2 was given written information, and group 3 had had previous surgical experience. The Spielberger State Anxiety Inventory (STAI-S), Dental Fear Scale (DFS), Modified Dental Anxiety Scale (MDAS), and visual analog scale (VAS) were used pre- and postoperatively to evaluate dental anxiety. RESULTS: The MDAS and VAS scores of all patients had decreased postoperatively (P = .012 and P < .001, respectively). The postoperative MDAS and VAS scores were lower than the preoperative scores in women (P = .007 and P < .001, respectively). The postoperative MDAS (P = .014 and P = .004, respectively) and VAS (P < .001 and P = .002) scores had decreased compared with the preoperative scores in groups 2 and 3. The preoperative and postoperative MDAS and VAS scores were similar in group 1. In addition, the preoperative and postoperative STAI-S and DFS scores were similar in all groups. CONCLUSIONS: All patients should be adequately informed about the third molar extraction procedure, even if they have previous experience. Providing detailed information reduced the postoperative anxiety of the patients.