Effect of Throat Pack Use on Postoperative Sore Throat in Nasal Surgeries: A Prospective Observational Study.

Abstract

Background: Postoperative sore throat (POST) is a common complication following general anesthesia in ENT and nasal surgeries, where surgical bleeding into the pharynx is a well-documented concern. Throat packs are used to absorb blood, secretions, and debris to reduce aspiration risk, but mechanical irritation of the delicate pharyngeal mucosa may result in mucosal trauma and postoperative airway discomfort.

Objectives: The objective of the study is to compare the occurrence and severity of POST in nasal surgeries performed with and without throat pack insertion.

Methodology: This prospective observational study was conducted at a tertiary care hospital between April 2024 and May 2025. Seventy-two adult patients (20-60 years), American Society of Anesthesiologists (ASA) physical status I-II, undergoing elective nasal surgeries under general anesthesia with endotracheal intubation, were enrolled. Patients were divided into two groups: Group I (with a throat pack, n = 36) and Group II (without a throat pack, n = 36). POST was assessed at 2, 24, and 48 h postoperatively using the Harding and McVey scoring system. Statistical analysis was performed using SPSS v29.0, with P < 0.05 considered statistically significant.

Results: POST was observed in both groups; however, its occurrence and severity were significantly higher in the throat pack group. All patients in Group I experienced POST, compared to 94.4% in Group II. Moderate-to-severe sore throat was more common in Group I during the early postoperative period. The duration of surgery showed a significant association with POST (P = 0.047), whereas ASA grade and type of surgery did not demonstrate significant associations.

Conclusion: POST was observed in both the throat pack and the no throat pack groups. Considering the potential risk of blood and saline aspiration during nasal surgeries, the use of a throat pack may be advocated as a protective measure in all nasal procedures. Careful insertion, appropriate sizing, and timely removal of the throat pack are essential to minimize pharyngeal mucosal trauma while ensuring patient safety.