Effect of Intraoperative Ice Pack Application on Postoperative Pain, Edema, and Ecchymosis in Rhinoplasty: A Randomized Controlled Trial.

BACKGROUND

Pain, periorbital edema, and ecchymosis are common after rhinoplasty. Intraoperative ice pack application may reduce these sequelae.

OBJECTIVE

To compare 5- and 10-min intraoperative ice pack application with no intraoperative cooling after rhinoplasty.

METHODS

Thirty-three patients undergoing primary reduction rhinoplasty were randomized to 5-min ice pack application (Group A, n = 11), 10-min ice pack application (Group B, n = 11), or no intraoperative ice pack application (Group C, n = 11). Periorbital edema (0-4), ecchymosis (0-5), and pain (0-10 VAS) were assessed on postoperative days 1, 3, and 7.

RESULTS

Pain scores were lower in both ice pack application groups than in the control group on postoperative days 1 (Group A: 4.46 ± 0.72; Group B: 3.96 ± 0.85; Group C: 5.46 ± 0.93; p = 0.003) and 3 (Group A: 3.82 ± 0.56; Group B: 3.41 ± 0.86; Group C: 5.09 ± 0.63; p < 0.001). Edema did not differ among groups on days 1 or 3 but was lower in Groups A and B on day 7 (Group A: 0.09 ± 0.25; Group B: 0.09 ± 0.29; Group C: 0.36 ± 0.47; p = 0.019). Ecchymosis did not differ among groups at any time point.

CONCLUSIONS

Intraoperative ice pack application was associated with lower pain scores after rhinoplasty. No significant reduction in ecchymosis was observed, and the effect on edema was limited.