Effect of Replacing the Pharyngeal Pack After Surgical Preparation with Chlorhexidine- or Normal Saline-Soaked Packs on Postoperative Throat Pain and Burning Following Oral and Maxillofacial Surgery

Purpose Pharyngeal packs are commonly used during oral and maxillofacial surgery to limit blood ingestion and aspiration of surgical debris. However, packing and residual povidone-iodine from surgical preparation may irritate the pharyngeal mucosa and contribute to postoperative throat discomfort. This study compared chlorhexidine-soaked and saline-soaked replacement pharyngeal packs for reducing postoperative throat pain and irritation. Methods In this prospective, randomized, double-blind clinical trial, 66 patients undergoing oral and maxillofacial surgery at Farhikhtegan Hospital were randomly assigned to receive a replacement pharyngeal pack soaked in either 0.2% chlorhexidine gluconate or 0.9% normal saline after routine preparation with diluted povidone-iodine. Throat pain and irritation were assessed by blinded investigators at 2, 4, 6, and 12 hours postoperatively using a 0–10 visual analog scale (VAS) and a five-point Likert scale. Repeated-measures analysis evaluated group, time, and group-by-time effects. Results The groups were comparable in age and sex distribution. Overall, VAS scores were significantly lower in the chlorhexidine group for throat irritation (P = 0.002) and throat pain (P = 0.001). Both outcomes decreased significantly over time (P < 0.001). Group-by-time interactions were not significant for irritation (P = 0.753) or pain (P = 0.348), indicating similar patterns of improvement. Between-group differences were not significant for Likert irritation (P = 0.260) or pain scores (P = 0.065). Conclusion Chlorhexidine-soaked replacement pharyngeal packs were associated with lower early postoperative VAS throat pain and irritation than saline-soaked packs. However, this benefit was not confirmed by Likert-scale assessments. Further trials should evaluate clinical significance and safety in larger, procedure-specific populations with longer postoperative follow-up.