Comparison of the Effect of Dexamethasone and Tranexamic Acid, Separately or in Combination on Post-Rhinoplasty Edema and Ecchymosis

• DOI: 10.1007/s00266-017-0969-x
• Publication Date: 2017-10-04T16:53:37Z
• Authors: Mohammad Mehdizadeh; Alireza Ghassemi; Mohammad Khakzad; Mehrafza Mir; Leili Nekoohesh; Aliakbar Moghadamnia; Ali Bijani; Zahra Mehrbakhsh; Hosein Ghanepur
• Keywords: Adult; Male; Analysis of Variance; Adolescent; Ecchymosis; Rhinoplasty; Dexamethasone; Statistics, Nonparametric; 3. Good health; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Double-Blind Method; Tranexamic Acid; Eyelid Diseases; Edema; Humans; Drug Therapy, Combination; Female; Prospective Studies; Infusions, Intravenous; Follow-Up Studies; Pain Measurement

Dexamethasone and tranexamic acid are used to decrease post-rhinoplasty periorbital edema and ecchymosis. We compared the impact of each medication separately or in combination in this regard.A prospective, randomized triple-blinded study was undertaken on 60 patients who underwent primary open rhinoplasty. They were divided into four groups: Group D (n = 15) received 8 mg dexamethasone, group T (n = 15) received 10 mg/kg tranexamic acid, group DT (n = 15) received both 8 mg dexamethasone and 10 mg/kg tranexamic acid, and group P (n = 15) received neither medication and served as the placebo control group. The medications were given intravenously (IV) 1 h before and three doses every 8 h postoperatively. Digital photographs were taken on the first, third and seventh postoperative days. One expert examiner blinded to the study evaluated the periorbital edema and ecchymosis on a scale of 0-4. Periorbital edema and ecchymosis were examined in all groups.In group D, group T and group DT, periorbital edema and ecchymosis ratings were significantly lower compared with the control group (p < 0.01). No statistically significant difference was seen in preventing or decreasing both periorbital edema and ecchymosis among group D, group T and group DT.Tranexamic acid and dexamethasone, separately or in combination, had similar effects in reducing periorbital edema and ecchymosis in open rhinoplasty. Combined application did not show a significantly higher beneficial effect in this regard.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 .