Objective
• Packing of the nasal cavity before operation to provide local anesthesia with lignocaine (Xylocaine) 4 percent.
• To provide vasoconstriction and hemostasis for the surgeon with 5 to 10 percent cocaine solution with 1 in 10,000 adrenaline added.
• Too much adrenaline may cause ventricular fibrillation.
• Packing of nasal cavity is also done for epistaxis to control bleeding.
Position
Supine.
Procedure
1. The ribbon gauze is impregnated with solution, and one or both nasal cavities are packed using a nasal speculum and dressing forceps.
2. The ribbon gauze is first passed along the floor of the cavity, and successive layers are built up until it is filled.
3. The pack is left in place for at least 15 minutes before operation, and is removed gently to avoid trauma of the nasal mucosa.
4. Spraying the nose with 5 percent cocaine first makes packing with ribbon gauze less unpleasant if the patient is conscious.
Instruments
• Speculae nasal (Thudichum), different sizes (Fig. 16.28)
• Dressing forceps, nasal (Tilley or Wilde) (Fig. 16.32)
• Nasal foreign body hook
• Roll of 25 mm (1 in) ribbon gauze
• Lignocaine 4 percent
• Adrenaline 1 in 10, 000
• Graduated measure, 15 ml (1/2 oz)
• Head light, or head mirror and lamp
• Towel or swab to protect the patient’s lips.
Any questions be sent to drmmkapur@gmail.com
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