Removal of nasal pack after septoplasty causes pain and anxiety in patients. Xylocaine 4% solution used as topical anesthetic reduces pain and anxiety if infiltrated postoperatively into nasal packing. Objective: To evaluate the effect of xylocaine 4% solution on patient's anxiety infiltrated in to nasal pack after septoplasty. Material and Methods: This prospective case control study conducted at the ENT and Psychiatry departments of Gajju Khan Medical College (GKMC) Swabi from June 2019 to

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... ember 2019. A total of 100 patients who underwent septoplasty with bilateral antibiotic ointment soaked nasal packing were randomly divided in to two groups, A & B. Xylocaine 4% solution (5ml in each nostril) was infiltrated into nasal pack in 50 patients in group A while group B including 50 patients were infiltrated with liquid paraffin (5ml in each nostril) fifteen minutes before nasal pack removal. Results: A total of 100 patients were included with age ranging from 18 to 40 years with a mean age of 25.2 years with male predominance. Hamilton anxiety scale scores in Xylocaine group were11.81+3.47, 15.05+2.99 and 10.6+3.51 at 24 hrs before surgery, 24hrs after surgery and 20 minutes after pack removal while 10.4+4.34, 14.21+4.13 and 12.6+4.54 were in the liquid paraffin group which suggests that anxiety was less in the xylocaine group at 20 minutes after pack removal. Conclusion: There was significant reduction in pain and anxiety after infiltration of xylocaine 4% solution into nasal pack post septoplasty. KEY WORDS: Xylocaine, Anxiety, Septoplasty