Effect of Steroids on Edema, Ecchymosis, and Intraoperative Bleeding in Rhinoplasty
- 1 December 2003
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Plastic Surgery
- Vol. 51 (6), 570-574
- https://doi.org/10.1097/01.sap.0000095652.35806.c5
Abstract
A double-blind, randomized study was designed to determine the efficacy of dexamethasone in decreasing periorbital edema and ecchymosis after rhinoplasty. Sixty rhinoplasty patients undergoing hump resection and lateral osteotomy were included in the study and were divided into 6 groups: group 1 (n = 10), single dose of 8 mg intravenous (IV) dexamethasone 1 hour before the operation; group 2 (n = 10), single dose of 8 mg IV dexamethasone at the beginning of the operation; group 3 (n = 10), 3 doses of 8 mg IV dexamethasone 1 hour before the operation, and 24 and 48 hours after the operation; group 4 (n = 10), 3 doses of 8 mg IV dexamethasone at the beginning of the operation, and 24 and 48 hour after the operation; group 5 (n = 10), 3 doses of 8 mg IV dexamethasone immediately after the operation, and 24 and 48 hours after the operation; group 6 (n = 10), control, no dexamethasone administration before or after the operation. Intraoperative blood loss was recorded for each patient. Patients were evaluated at 24 hours and days 2, 5, 7, and 10. For the postoperative evaluation of periorbital ecchymosis and edema, a scale of 0 to 4 points was used. There was no significant difference between groups in terms of bleeding (P > 0.05). In the groups using steroid before osteotomy, edema and ecchymosis were significantly lower during the first 2 days compared with the control group (P < 0.05). No significant difference was seen between groups 1 and 2. When patients were evaluated on day 5, edema and ecchymosis were significantly lower in groups 3 and 4 (P < 0.05) compared with other groups, but there was no difference between them. Group 5 had a significantly higher level of edema and ecchymosis compared with groups 1 through 4 at 24 hours and at days 2, 5, and 7 (P > 0.05). There was no significant difference between groups on day 10. In conclusion, if the first dose is given before osteotomy, triple-dose steroid application is the best bet for decreasing postoperative edema and ecchymosis. None of the patients had any complications related to the use of dexamethasone.Keywords
This publication has 16 references indexed in Scilit:
- Effects of Single-Dose Steroid Usage on Edema, Ecchymosis, and Intraoperative Bleeding in RhinoplastyPlastic and Reconstructive Surgery, 1999
- Does Steroid Medication Reduce Facial Edema Following Face Lift Surgery? A Prospective, Randomized Study of 30 Consecutive PatientsPlastic and Reconstructive Surgery, 1996
- Effects of Steroids on Mood, Edema, and Ecchymosis in Facial Plastic SurgeryJAMA Otolaryngology–Head & Neck Surgery, 1994
- Evaluation of dexamethasone for reducing postoperative edema and inflammatory response after orthognathic surgeryJournal of Oral and Maxillofacial Surgery, 1994
- Steroids and Rhinoplasty: A Double-blind StudyJAMA Otolaryngology–Head & Neck Surgery, 1991
- Steroids in rhinoplastyThe Laryngoscope, 1989
- The effect of methlyprednisolone on pain, trismus, and swelling after removal of third molarsOral Surgery, Oral Medicine, Oral Pathology, 1986
- Effect of methylprednisolone on swelling after orthognathic surgeryJournal of Oral and Maxillofacial Surgery, 1984
- Experimental facial edema: Treatment with methyl prednisoloneJournal of Surgical Research, 1978
- Prevention of post‐rhinoplasty edemaThe Laryngoscope, 1974