9
Table 7. Adjunctive Measures to Pain Management in
Rhinoplasty
Adjunctive
Measure Indication Uses
Perioperative
steroids
8–12 mg decadron
preoperatively with
a single additional
dose in the next 24
hours
Reduces swelling,
nausea, and
vomiting
May reduce pain;
May decrease
the duration of
post-operative
ecchymosis
Postoperative nasal
irrigation
High volume / low
pressure nasal saline
and fluticasone
irrigation
postoperatively
Reduces nasal
crusting and nasal
airway patency,
possibly improving
patient satisfaction
Will require patient
instruction and
education
Arnica Montana 3 times per day May reduce the
amount of early
postoperative
swelling, but has
no influence on
ecchymosis
May increase the
risk of bleeding
Avoiding the
placement of
packing
Reduces
postoperative
discomfort
Not necessary in
patients that are not
bleeding
Should be used if
there is persistent
surgical bleeding
Intra-operative
cold compresses
Iced saline gauze
packs on the
external nose
during surgery
Reduces
intraoperative
bleeding, surgical
time, and
postoperative
edema
May increase
comfort
