Assessment Of The Efficacy Of The Treatment Methods Of Epistaxis And The Level Of The Pain/Discomfort Experienced With Each Method In Adult Patients

Hadi Khammas, Ammar; Radef Dawood, Mohammed; Khadhair Hamad, Abbas

	Assessment Of The Efficacy Of The Treatment Methods Of Epistaxis And The Level Of The Pain/Discomfort Experienced With Each Method In Adult Patients
Mustansiriya Medical Journal
Article 1, Volume 16, Issue 1, 2017, Pages 23-28
Authors
Ammar Hadi Khammas; Mohammed Radef Dawood; Abbas Khadhair Hamad
Abstract
Objectives: To assess the effectiveness and the level of the patient’s pain/discomfort experienced by different procedures applied for the treatment of the epistaxis in adult patients. Patients and methods: A prospective observational study of 121 adult patients presented with epistaxis, from January 2016 to September 2016, at ENT Department in Al-Yarmouk Teaching Hospital in Baghdad, all the patients had been received an adequate treatment modalities accordance to a standard regimen, and at the end of each procedure, the level of their pain/discomfort experienced was assessed according to Visual Analogue Scale (VAS) questionnaire, and the success rate for each procedure was evaluated. Results: The median VAS score for pain/discomfort in the anterior epsitaxis was in the following order; 1.5, 2.5, and 6, for chemical cauterization, electrical cauterization, and nasal packing, respectively, while for posterior epistaxis was 3, 3.5, 6, and 7.5, for electrical cauterization, endoscopic sphenoplatine artery ligation (ESPAL) surgery, nasal packing, and post nasal Foley's catheterization, respectively. The success rate for the anterior epistaxis treatment modalities was 89.36%, 78.37%, and 75%, for electrical cauterization, chemical cauterization, and nasal packing respectively, while for the posterior epistaxis; was 68.18%, 90%, 75%, and 100%, for nasal packing, electrical cauterization, Foley's post nasal catheterization, and (ESPAL) surgery respectively. Conclusions: In the anterior epistaxis; the pain/discomfort experienced score for both chemical and electrical cauterization was mild, but the success rate was higher with electrical cauterization, while in the posterior epistaxis; both the endoscopic electrical cauterization, and the (ESPAL) surgery were associated with high patient`s tolerability, however the (ESPAL) surgery was found to be a superior method as associated with the highest success rate.
Keywords
Epistaxis; VAS score; Electrical cauterization; Chemical cauterization

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