title: Preoperative Use of Dexamethasone in Rhinoplasty: A Randomized, Double-blind, Placebo-Controlled Clinical Trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled clinical trial at an institutional referral center among a sample of individuals with rhinomegaly.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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.
  
  
  METHODS
  1.
authors.affiliation: Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Denis S
authors.initials: DS
authors.lastname: Valente
authors.affiliation: Division of Plastic Surgery, Santa Casa Hospital, Porto Alegre, Brazil.
authors.forename: Niveo
authors.initials: N
authors.lastname: Steffen
authors.affiliation: Division of Plastic Surgery, Santa Casa Hospital, Porto Alegre, Brazil.
authors.forename: Lauro A
authors.initials: LA
authors.lastname: Carvalho
authors.affiliation: Division of Plastic Surgery, Santa Casa Hospital, Porto Alegre, Brazil.
authors.forename: Giuliano B
authors.initials: GB
authors.lastname: Borille
authors.affiliation: Division of Dermatologic Surgery, Mãe de Deus Health System, Porto Alegre, Brazil.
authors.forename: Rafaela K
authors.initials: RK
authors.lastname: Zanella
authors.affiliation: Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Alexandre V
authors.initials: AV
authors.lastname: Padoin
mesh_terms: D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004438:Ecchymosis / Q000517:prevention & control*; D004487:Edema / Q000517:prevention & control*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D007430:Intraoperative Care; D008297:Male; D010919:Placebos; D011183:Postoperative Complications / Q000517:prevention & control*; D012225:Rhinoplasty; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D010919:Placebos; D003907:Dexamethasone