Use of phenylephrine-soaked gauze following staphylectomy does not reduce the need for reintubation or temporary tracheostomy in brachycephalic dogs.

Phenylephrine-soaked gauze after staphylectomy does not reduce reintubation or temporary tracheostomy rates in brachycephalic dogs.

This retrospective study evaluated whether application of phenylephrine-soaked gauze (PG) against the soft palate following staphylectomy reduces postoperative reintubation and temporary tracheostomy rates in brachycephalic dogs. Electronic medical records from January 2023 through December 2024 were reviewed, yielding 96 dogs divided into a PG group (n=56) and a no-phenylephrine gauze group (NPG, n=43). Phenylephrine is a vasoconstrictive alpha-1 adrenergic agonist theoretically capable of reducing soft palate mucosal edema and hemorrhage following surgical resection, which could improve postoperative airway patency. Baseline characteristics were largely comparable between groups, though the NPG group had a higher proportion of dogs with stage I laryngeal collapse versus stage II compared to the PG group—a potential confounding factor favoring the NPG group. Despite this, reintubation rates (PG: 19.6% vs. NPG: 22.5%) and temporary tracheostomy rates (PG: 7.1% vs. NPG: 5.0%) were not statistically different between groups. Statistical analyses included Student's t-test, Wilcoxon test, and Fisher's exact test as appropriate. The study concludes that PG application confers no measurable benefit in reducing postoperative airway compromise following staphylectomy. Limitations include the retrospective design, moderate sample size, and the imbalance in laryngeal collapse staging between groups. The authors recommend that clinicians explore alternative strategies—such as corticosteroids, laser-assisted surgery, or other anti-inflammatory approaches—to mitigate postoperative soft palate swelling in brachycephalic obstructive airway syndrome (BOAS) patients.

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