Efficacy of dexamethasone with controlled hypotension on intraoperative bleeding, postoperative oedema and ecchymosis in rhinoplasty

Testing the effects of long-acting steroids in edema and ecchymosis after closed rhinoplasty

“…Previous randomized controlled trials have implemented prednisone (4,17), methylprednisolone (2,9-11), betamethasone (2) and dexamethasone (2)(3)(4)(5)14,16), among others, and have suggested better results if high and repeated doses are given versus placebo, in most cases (1)(2)(3)(4)(5)9,10). Most reports present isolated findings of one type of steroid compared with placebo; two studies, however, have reported conflicting results.…”

“…Other types of measures, either alone or in conjunction with steroids, have been used in an attempt to reduce these sequelae, such as arnica (15), controlled hypotension during surgery (16) and cold saline gauze compression throughout surgery (14), among others.…”

Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach

“…Eyelid edema and periorbital ecchymosis were significantly decreased by the combination of dexamethasone and hypotension on the 7th and 10th postoperative day. 18 The quality of the surgical field in endoscopic sinus surgery has been found to improve most due to reduced bleeding if the mean arterial pressure was kept at 40 to 59 mm Hg. 19 In this study, the middle cerebral artery blood flow velocity was reduced by >50% in >10% of the time points if the mean arterial pressure was below 60 mm Hg.…”

The efficacy of steroids for edema and ecchymosis after Rhinoplasty: A meta‐analysis

“…Some studies report improvement in outcomes such as edema, ecchymosis, and intraoperative bleeding; however, other studies conclude that steroid use is unnecessary and may even be disadvantageous . Additionally, steroids are administered as a single or multiple dose . There is no consensus in the extant medical literature on how many doses of steroids, if any, is the optimal treatment modality …”