Correction of pain syndrome with the inclusion of angioprotectors in the complex therapy of rhinosurgical patients

Aim. To increase the effectiveness of postoperative treatment of patients undergoing rhinosurgery by including a drug with angioprotective effect in complex therapy.
Material and methods. The study included data from 63 patients aged 20–56 years: 32 patients in the main group who received standard postoperative treatment in combination with L-lysine escinate for 5 days, and 31 patients in the control group who received standard therapy. All patients underwent surgical correction of nasal septum deformity for J34.2 in combination with vasomotor rhinitis J30.0 and had concomitant tension headache G44.2. The analysis was performed only according to baseline data and tables. The categorical results in the original table were presented as percentages.; For cross-group comparisons, the percentages were converted to absolute frequencies, taking into account the volume of the corresponding group, adjusted to the nearest whole patient, if necessary, and then recalculated back to percentages. The Mann–Whitney criterion was used for ordinal outcomes, the Fisher exact criterion with relative risk (RR) and 95% confidence interval was used for binary clinically favorable outcomes, and the anterior active rhinomanometry data was compared with published averages of M±m. The statistical significance level was assumed to be 0.05.
Results. Before surgery, the groups were comparable in severity of nasal congestion, impaired sense of smell, impaired nasal breathing and mucociliary transport (for all comparisons, p≥0.987). On day 3, a statistically significant advantage of the main group was found in olfactory impairment (p=0.031), while the differences in nasal congestion and nasal breathing had not yet reached significance (p=0.375 and p=0.141, respectively). On day 5, intergroup differences became significant in all major clinical outcomes: nasal congestion (U=17.0; p<0.001), sense of smell (U=9.0; p<0.001), nasal breathing (U=193.0; p<0.001), mucociliary transport (U=81.5; p<0.001). The proportion of patients with absent or mild nasal congestion was 100.0% versus 54.8% (RR=1.80, 95% CI 1.31–2.48), with normosmia or mild hyposmia – 100.0% versus 58.1% (RR=1.70, 95% CI 1.26–2.30), with absent or mild nasal breathing disorder – 100.0% versus 54.8% (RR=1.80, 95% CI 1.31–2.48). On day 14, the advantage of the main group remained in nasal congestion (U=205.5; p<0.001), sense of smell (U=176.0; p<0.001), nasal breathing (U=272.0; p<0.001) and mucociliary transport (U=6.0; p<0,001). The indicators of anterior active rhinomanometry in the main group were higher on days 3, 5, and 14 (Δ72.5, Δ165.1, and Δ181.7 cm3/s; for all comparisons; p<0.001). The indicators of cephalgia and SF-36 in the initial materials were presented only as aggregated averages, therefore they are presented as descriptive dynamics without formal intergroup testing.
Conclusion. The addition of L-lysine escinate to standard therapy after rhinosurgery is associated with faster regression of edema and pain, earlier restoration of smell, nasal breathing, and improvement of objective indicators of nasal ventilation function. The most convincing intergroup differences were observed on the 5th and 14th days after surgery.
Keywords: rhinosurgery, nasal septum deformity, vasomotor rhinitis, angioprotector, L-lysine escinate, quality of life
Conflict of interest. The authors declare no conflict of interest.
Financing. The study was performed without external funding