The Hemostatic Effect of Desmopressin on Bleeding as a Nasal Spray in Open Septorhinoplasty.

Abstract

Rhinoplasty is associated with intraoperative bleeding which affects the quality of the operation and may increase the time of surgery. The aim of this study was to assess the role of nasal spray of desmopressin on reduction in intraoperative bleeding during elective open rhinoplasty. Conducting an interventional study in our hospital, all patient data including demographic information, medical history and laboratory tests before surgery were collected. Patients who were randomly divided into two study groups, received nasal desmopressin spray or placebo spray, 60min before starting open septorhinoplasty. The measured variables included: bleeding volume, the operative field quality in regard to bleeding (Boezaart score), the surgeons' satisfaction in regard to bleeding during surgery (Likert scale), postoperative bruising, postoperative bleeding and menstruation. Thirty cases were studied; 13 (46.3%) people received placebo and 17 (56.7%) received desmopressin. The Boezaart score, satisfaction scores, bleeding volume, upper eyelid ecchymosis in the group receiving desmopressin were significantly better than the control group. Postoperative bleeding was also less in the desmopressin group, but not significant as other variables. In women of each group, menstruation had no effect on the amount of bleeding, surgical field quality and surgeon satisfaction compared with non-menstruation women. Nasal desmopressin use is an effective method for reducing intraoperative and postoperative bleeding and diminished postoperative ecchymosis which improves surgeons' satisfaction. So using the nasal form of desmopressin could be considered as method of controlling bleeding and ecchymosis in open rhinoplasty. 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.