Effect of a combination of rhinoplasty and septoplasty on the development of acute postoperative syndrome and cortisol secretion into blood plasma

Abstract

Purpose of the study: to evaluate the effect of a combination of rhinoplasty and septoplasty on the development of acute postoperative syndrome and the secretion of cortisol into the blood plasma.Material and methods. A study was conducted in a group of 98 patients who underwent septoplasty, rhinoplasty or rhinoseptoplasty. Using a Digital Rating Scale, the intensity of pain was assessed 3, 6, 24, 48 hours after the end of surgery. The day before, immediately before and 6 hours after surgical interventions, all patients underwent blood sampling to determine the concentration of cortisol in the blood plasma. The data obtained were compared within groups over time, as well as between groups at the corresponding assessment points.Results. The intensity of pain 3 hours after surgery was significantly lower in the group of patients after rhinoplasty and significantly decreased after 6 (p < 0.001), 24 (p < 0.01), 48 (p < 0.001) hours after surgery, compared with patients who underwent septoplasty and rhinoseptoplasty. In the early postoperative period, patients from the rhinoplasty group had the lowest cortisol concentrations in the blood plasma, compared with patients after septoplasty (p < 0.001) and rhinoseptoplasty (p < 0.01). In patients who underwent rhinoseptoplasty, the level of cortisol in the blood was significantly higher compared with patients after septoplasty (p < 0.01).Conclusion. The assessment of acute pain using a digital rating scale after rhinosurgical interventions showed that septoplasty provokes the development of a stronger acute pain syndrome in the early postoperative period, which proves its trauma compared to rhinoplasty. Simultaneous rhinoplasty and septoplasty in the first days after surgery contributes to an increase in the concentration of cortisol in blood plasma, as well as an increase in pain syndrome.