From the Guidelines
For epistaxis (nosebleed) management, Nasopore is generally the preferred option among these three nasal packing materials due to its biodegradable nature, which reduces patient discomfort and eliminates the need for removal, thus minimizing the risk of rebleeding and improving quality of life 1.
Key Considerations
- Nasopore is a biodegradable synthetic polyurethane foam that provides good hemostasis while being more comfortable for patients as it softens and eventually dissolves (typically within 5-14 days) 1.
- Merocel is a compressed polyvinyl alcohol sponge that expands when moistened and provides excellent hemostasis, but requires removal after 2-3 days, which can be uncomfortable and may cause rebleeding 1.
- Rhino Rocket is a pneumatic nasal tampon that can be inflated to provide pressure against bleeding sites, offering good hemostasis but may cause more discomfort and also requires removal 1.
Recommendations
- When using any of these products, they should be properly placed along the floor of the nasal cavity and, if applicable, moistened according to manufacturer instructions 1.
- Patients should be advised to avoid strenuous activity, nose-blowing, and blood thinners while packing is in place.
- The choice ultimately depends on the severity of bleeding, location, patient comfort considerations, and physician preference.
Outcomes
- Control of acute bleeding
- Prevention of recurrent episodes of nasal bleeding
- Complications of treatment modalities
- Accuracy of diagnostic measures
- Quality of life (QOL) 1
From the Research
Comparison of Rhino Rocket, Merocel, and Nasopore for Epistaxis
- The effectiveness of Rhino Rocket, Merocel, and Nasopore in managing epistaxis has been studied in various research papers 2, 3, 4, 5, 6.
- A study comparing the pain of insertion and removal of Rapid Rhino and Rhino Rocket nasal tampons found that the Rapid Rhino was less painful to insert and easier to remove than the Rhino Rocket, while both were similarly effective at stopping nosebleeds 5.
- Another study found that Nasal packing appears to be more effective when applied by trained professionals, and that Rapid Rhino packs were the most tolerated non-dissolvable packs 6.
- The re-bleed rates for Rapid Rhino and Merocel were similar, but were higher with bismuth iodoform paraffin paste packing 6.
- Limited evidence suggests that dissolvable packs, such as Nasopore, are effective and well tolerated by patients 6.
- A literature review found that nasal packing can be applied with non-absorbable materials, such as Merocel, and absorbable materials, such as Nasopore, and that newer hemostatic materials are more effective and have fewer complications 2.
Key Findings
- Rhino Rocket and Merocel have similar re-bleed rates 6.
- Rapid Rhino is less painful to insert and easier to remove than Rhino Rocket 5.
- Nasopore is a dissolvable pack that is effective and well tolerated by patients 6.
- Newer hemostatic materials are more effective and have fewer complications than traditional nasal packing materials 2.