Preoperative Use of Dexamethasone in Rhinoplasty: A Randomized, Double-blind, Placebo-Controlled Clinical Trial.

Autor:	Valente DS; Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil., Steffen N; Division of Plastic Surgery, Santa Casa Hospital, Porto Alegre, Brazil., Carvalho LA; Division of Plastic Surgery, Santa Casa Hospital, Porto Alegre, Brazil., Borille GB; Division of Plastic Surgery, Santa Casa Hospital, Porto Alegre, Brazil., Zanella RK; Division of Dermatologic Surgery, Mãe de Deus Health System, Porto Alegre, Brazil., Padoin AV; Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Jazyk:	angličtina
Zdroj:	JAMA facial plastic surgery [JAMA Facial Plast Surg] 2015 May-Jun; Vol. 17 (3), pp. 169-73.
DOI:	10.1001/jamafacial.2014.1574
Abstrakt:	Importance: Postoperative edema and ecchymosis following rhinoplasty are a cause of anxiety for both patients and physicians and can affect the cosmetic results. Corticosteroids have been used to reduce these events. Objective: To determine whether preoperative use of dexamethasone sodium phosphate alters the occurrence of edema and ecchymosis following rhinoplasty. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled clinical trial at an institutional referral center among a sample of individuals with rhinomegaly. Interventions: Patients were randomized into 2 groups. In group 1, dexamethasone was intravenously injected before surgery. In group 2, normal saline solution was intravenously injected before surgery. Main Outcomes and Measures: When patients returned at 1 week after surgery, standardized photographs were obtained. The photographs were analyzed by 5 plastic surgeons who were blinded as to whether dexamethasone or normal saline solution had been injected. The plastic surgeons rated the degree of edema and ecchymosis. Results: Forty-two patients participated in the study. Randomization by lottery resulted in 20 patients in group 1 and 22 patients in group 2. Group 1 showed lower rates of postoperative ecchymosis than group 2; the difference of 0.62 (P = .02) reflects less perceived ecchymosis when dexamethasone was administered. Group 1 also showed lower rates of postoperative edema than group 2; the difference of 0.68 (P = .01) reflects less perceived edema when dexamethasone was administered. Conclusions and Relevance: Preoperative use of dexamethasone reduced edema and ecchymosis at 7 days after rhinoplasty. Rigorous methods in this trial demonstrate the beneficial effect of preoperative corticosteroid administration in this surgical procedure. Level of Evidence: 1.
Databáze:	MEDLINE
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