Effect on patient anxiety of lidocaine infiltration into nasal packing after septoplasty: prospective, controlled study C SAHIN 1 , H I ARAS 2 1 ENT Clinic and 2 Psychiatry Clinic, Sakarya Akyazi State Hospital, Sakarya, Turkey Abstract Objective: This prospective, controlled study investigated the effect on patient anxiety of lidocaine infiltration into nasal packing following septoplasty. Methods: The study included 50 patients who underwent septoplasty operation. Patient anxiety levels were measured 24 hours pre-operatively; 48 hours post-operatively, before saline or lidocaine infiltration; and 15 minutes after lidocaine or saline infiltration into the packing. The patients were asked to mark their level of pain during pack removal on a visual analogue scale. Results: Hamilton Anxiety Scale scores for lidocaine infiltration patients were: 15.1 ± 7.4 pre-operatively; 16 ±7.6 post-operatively, before infiltration; and 13.7 ± 6.6 at 15 minutes after infiltration. The scores for saline infiltration patients were: 16.3 ± 6.8 pre-operatively, 16.4 ± 5.5 before infiltration and 16.1 ± 6.1 after infiltration. The visual analogue scale pain score was 5.3 ± 2.0 in the lidocaine study group and 7.5 ± 1.8 in the control saline group. Conclusion: Infiltration of lidocaine into nasal packing significantly reduced patient pain. Patients developed mild to moderate anxiety before nasal packing removal. Use of techniques without nasal packing can be recommended after septoplasty to ease patient post-operative discomfort. Key words: Anxiety; Nasal Surgical Procedures; Test Anxiety Scale Introduction Septoplasty is one of the most common surgical proce- dures performed in ENT clinics. Intranasal packing is widely used post-operatively for nasal septum stabilisa- tion and bleeding control. Merocel nasal tampons (Medtronic-Xomed, Jacksonville, Florida, USA) are often preferred after surgery because of their ease of use and clinical efficacy. 1 Patients experience pain after septoplasty during the removal of nasal packings. 2 These patients may be concerned about pain before nasal packing removal, thus increasing anxiety levels. Various methods are currently employed to reduce this pain, and research is ongoing. 1 The infiltration of lidocaine before packing removal may reduce the pain experienced, which is an issue that has been inves- tigated previously. 2 Anxiety is a symptom that occurs when an individ- ual does not feel safe. The process of surgery can increase a patient’s anxiety levels. The prevention of anxiety will have a positive impact on a patient’s quality of life. Patients’ anxiety levels can be measured objectively using various tests (e.g. State-Trait Anxiety Inventory for state anxiety, Hamilton Anxiety Scale, and Hospital Anxiety and Depression Scale). 3 The Hamilton Anxiety Scale was used in this study. This prospective, controlled study aimed to investi- gate the effect on patient anxiety of lidocaine infiltration into packing (before removal) following septoplasty. Materials and methods This planned, controlled, prospective study comprised 50 patients who underwent septoplasty for nasal septum deviation. Informed consent was obtained from all participants. Patients with nasal polyposis, concha bullosa, or any additional nasal or paranasal pathology, were excluded from the study. All patients were evaluated by the same psychiatrist pre-operatively. Patients with any psychological dis- order were excluded from the study. Patients’ anxiety levels were measured, by the same psychiatrist, using the Hamilton Anxiety Scale. All patients were operated on (under general anaesthesia), and all nasal packing was removed, by the same surgeon. Post-operatively, 8 cm Merocel nasal packs (standard nasal dressing Accepted for publication 20 January 2015 First published online 29 June 2015 The Journal of Laryngology & Otology (2015), 129, 784–787. MAIN ARTICLE © JLO (1984) Limited, 2015 doi:10.1017/S0022215115001644