Pain relief after rhinoseptoplasty of various surgical areas

Aims: to justify the choice of anesthesia during rhinoseptoplasty with varying degrees of surgical trauma. Materials and methods. All patients underwent rhinoplasty on the cartilaginous and bony skeleton of the external nose, and septoplasty was performed depending on the location of the nasal septum deviation, that is, either in the cartilaginous region (Group 1) or in the cartilaginous and bony regions of the nasal septum (Group 2). In addition, each subgroup was compared to the efficacy of paracetamol and meloxicam (NSAIDs from the oxicam group) for relieving acute pain and minimizing stress reactions, depending on the size of the surgical field. Changes in pain intensity were assessed. Results. The efficacy of paracetamol as a non-selective cyclooxygenase inhibitor is insufficient for the complete relief of acute pain in the early postoperative period following open rhinoseptoplasty. In contrast, the use of a selective COX-2 inhibitor from the oxicam group (meloxicam) provides a significant reduction in pain intensity both when correcting the cartilaginous portion of the septum exclusively and when including the bony portion. Conclusion. The extent of the procedure influences the development of acute pain in the early postoperative period following nasal septum surgery. Expanding the surgical site by involving the bony portion of the nasal septum is accompanied by a significant increase in the intensity of acute postoperative pain compared to surgeries limited to the cartilaginous portion. The greatest pain intensity is recorded in the first hours after surgery, primarily in the 3rd and 6th hours after completion.
Key words: rhinoseptoplasty, pain syndrome, septoplasty, rhinoplasty, nasal septum
Conflict of interest. The authors have no conflicts of interest.
Funding. The work was completed without sponsorship.