title: Comparison of the Effects of Total Nasal Block and Central Facial Block on Acute Postoperative Pain, Edema, and Ecchymosis After Septorhinoplasty.
abstract: BACKGROUND
  Pain, ecchymosis, and edema are major postoperative transient complications of septorhinoplasty procedures. They increase the patient's anxiety and decrease satisfaction levels as well as extend recovery time in the early postoperative period. The aim of this study was to compare the effects of total nasal block (TNB) and central facial block (CFB) on postoperative pain, edema, and ecchymosis.
  
  
  METHODS
  A total of 60 consecutive patients enrolled in this study and were divided into three groups as Controls (n = 20), TNB (n = 20), and CFB (n = 20). The two block methods mentioned above were performed at both the beginning and end of the surgery in the TNB and CFB groups. The Control group was not subjected to any block methods. Pain, edema, and ecchymosis score results according to the three scales were recorded postoperatively after 24 h, and on days 2, 5, 7, and 10. Results were analyzed statistically.
  
  
  RESULTS
  Of all patients, 28 were male and 32 were female. Ages were between 18 and 52 years (mean = 26.3 years). Pain, edema, and ecchymosis scores were significantly lower in the TNB and CFB groups than in the Control group. Additionally, there was a significant difference between the TNB and CFB groups in terms of pain and edema at postoperative 24 h and on day 2. Ecchymosis scores were lower in the CFB group than in the TNB group at 24 h and on days 2 and 5 after the operation.
  
  
  CONCLUSIONS
  Both TNB and CFB decreased postoperative pain, edema, and ecchymosis in septorhinoplasty. However, CFB was more effective than TNB in terms of pain, edema, and ecchymosis relief after septorhinoplasty procedures.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Kırıkkale University, Ankara-Kirikkale Road 7th km Yahsihan, 71450, Kirikkale, Turkey. drelifsanli@hotmail.com.
authors.forename: Elif
authors.initials: E
authors.lastname: Sari
authors.affiliation: Department of ENT, Faculty of Medicine, Kırıkkale University, Kirikkale, Turkey.
authors.forename: Gokce
authors.initials: G
authors.lastname: Simsek
mesh_terms: D000293:Adolescent; D000328:Adult; D004438:Ecchymosis / Q000209:etiology* / Q000517:prevention & control*; D004487:Edema / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000009:adverse effects*; D055815:Young Adult
keywords: Ecchymosis; Edema; Postoperative pain; Rhinoplasty; Septorhinoplasty