Chapter 23 - Postoperative pain after rhinoplasty and rhinologic surgery

Abstract

Rhinoplasty is one of the most common facial plastic surgical procedures, performed for cosmesis or to improve breathing, while rhinologic surgery typically refers to endoscopic sinus surgery, performed to alleviate symptoms of chronic rhinosinusitis. Commonly coupled with these procedures is the straightening of a deviated septum, termed septoplasty. Recent studies have used different metrics to assess postoperative pain levels and the amount of opioid medications required for adequate postoperative analgesia following these surgical procedures, such as a visual analog scale (VAS) and morphine milligram equivalents (MME), respectively. These studies have largely demonstrated that postoperative pain after septorhinoplasty and rhinologic surgery is mild, with pain peaking in the first 1 to 3days after surgery and steadily declining afterward. Postoperative management after these surgeries should therefore be based on over-the-counter nonopioids taken as first-line agents, with opioids used as breakthrough or rescue agents as needed.