Bilateral Postprocedural Rhinitis After Intravenous Sedation With Supplemental Nasal Oxygen (PRAISE SNOG) After Cataract Surgery

Rhinitis is classified as allergic or nonallergic. It presents with nasal congestion, nasal pruritus, posterior nasal drainage, rhinorrhea, and/or sneezing. During short procedures, nasal cannula administration of supplemental oxygen may be utilized to prevent hypoxia. Postprocedural rhinitis after intravenous sedation with supplemental nasal oxygen (PRAISE SNOG) - a noninflammatory variant of nonallergic rhinitis - has been observed in colonoscopy patients. Symptoms (sneezing and/or rhinorrhea with or without tearing) typically begin during emergence from sedation and persist for hours to days before resolving. A 66-year-old woman developed bilateral PRAISE SNOG following cataract extraction; her bilateral symptoms of nasal pruritus, rhinorrhea, and sneezing began immediately after awakening from sedation and spontaneously resolved within 24 hours. Mucosal irritation by the nasal cannula prongs that deliver the oxygen is a postulated pathogenesis for postprocedural rhinitis. Modification of the nasal prong composition (by using a soft silicon-based material), placement (by insertion prior to the induction of sedation and by not impinging on the nasal mucosa), and length (by trimming from 10 to two millimeters) are possible actions that might be initiated in order to prevent PRAISE SNOG.