Effect on patient anxiety of lidocaine infiltration into nasal packing after septoplasty: a prospective, case-control study

Objective: The effect on patient anxiety of lidocaine infiltration into nasal packing following septoplasty was investigated by this prospective, case- control study. Methods: 60 patients, who underwent septoplasty operation with bilateral merocele nasal packing were included in this study. Nasal packs were infiltrated with 0.9% saline (5 mL in each nostril) for 30 patients and remaining 30 were infiltrated with 2% xylocaine (5 mL in each nostril), 15 minutes before nasal pack removal. Patient anxiety levels were measured at various time points i.e. 24 hours pre-operatively, 48 hours post operatively, 30 minutes after pack removal. Patients marked their level of pain on a visual analogue scale during pack removal. Results: Hamilton Anxiety Scale scores for saline infiltration patients were found to be (Mean ± SD) 12.3 ± 5.35, 16.23 ± 5.12 and 14.23 ± 4.55 for 24 hours pre-operatively, 48 hours post operatively, 30 minutes after pack removal respectively. The respective scores for lidocaine infiltration patients were: 13.83 ± 4.46, 17.07 ± 3.98 and 11.7 ± 3.52. at 24 hours before surgery, 48 hours after surgery and 30 minutes after pack removal. The visual analogue scale pain score was 5.6 ± 0.89 for Saline study group and 7.13 ± 0.73 in the lidocaine study group. Conclusion: Patient pain was significantly reduced following infiltration of lidocaine into nasal packing. Patients developed mild to moderate anxiety before nasal packing removal. Use of techniques without nasal packing like soluble packs or quilting methods after septoplasty for patient comfort can be recommended after septoplasty to ease patient post-operative discomfort.