Department of Burn and Plastic Surgery, Qingdao Municipal Hospital, Qingdao, 266000, Shandong, People's Republic of China.
Department of Otolaryngology Head and Neck Surgery, Qingdao Municipal Hospital, Qingdao, 266000, Shandong, People's Republic of China.
Aesthetic Plast Surg. 2020 Oct;44(5):1672-1684. doi: 10.1007/s00266-020-01743-w. Epub 2020 May 7.
Rhinoplasty is one of the most challenging cosmetic surgical operations. The procedure has been known to precipitate higher levels of edema and ecchymosis in the periorbital and paranasal regions. The literature recommends the use of corticosteroids such as dexamethasone to alleviate these postoperative morbidities. In this review, we aim to provide a current state of evidence concerning the influence of dexamethasone together with rhinoplasty on intraoperative and postoperative morbidities.
A systematic identification of the literature was performed according to PRISMA guidelines on four academic databases: MEDLINE, Scopus, EMBASE and CENTRAL. A meta-analysis compared the influence of dexamethasone and normal saline administered during rhinoplasty on the amount of intraoperative blood loss, postoperative edema and ecchymosis.
Out of 1045 records, ten articles including 374 participants (mean age: 25.8 ± 2.5 years) were included in this review. This systematic review presents a 1b level of evidence supporting the use of dexamethasone during rhinoplasty to reduce the amount of intraoperative blood loss, edema and ecchymosis as compared to normal saline. The meta-analysis reveals beneficial effects for dexamethasone interventions by demonstrating medium to large effect reduction of the amount of intraoperative blood loss (Hedge's g: - 0.69), mean edema score (- 1.09) and mean ecchymosis score (- 1.03) as compared to placebo groups using normal saline.
The current systematic review and meta-analysis recommend the administration of dexamethasone with rhinoplasty. The review reports beneficial effects of dexamethasone's administration as compared to normal saline for reducing the amount of intraoperative blood loss, postoperative edema and ecchymosis.
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 .
隆鼻术是最具挑战性的美容手术之一。该手术已知会在眶周和鼻旁区域引发更高水平的水肿和瘀斑。文献建议使用地塞米松等皮质类固醇来减轻这些术后并发症。在本次综述中，我们旨在提供关于地塞米松与隆鼻术联合应用对术中及术后并发症影响的最新证据。
根据 PRISMA 指南，我们在四个学术数据库（MEDLINE、Scopus、EMBASE 和 CENTRAL）中对文献进行了系统检索。Meta 分析比较了在隆鼻术中使用地塞米松和生理盐水对术中出血量、术后水肿和瘀斑的影响。
在 1045 条记录中，共有 10 篇文章（共 374 名参与者；平均年龄：25.8 ± 2.5 岁）纳入本综述。本系统评价提供了 1b 级证据，支持在隆鼻术中使用地塞米松来减少术中出血量、水肿和瘀斑，与生理盐水相比。Meta 分析显示，与生理盐水安慰剂组相比，地塞米松干预具有中等至较大的效应降低术中出血量（Hedge's g：-0.69）、平均水肿评分（-1.09）和平均瘀斑评分（-1.03）。
目前的系统评价和 Meta 分析推荐在隆鼻术中使用地塞米松。该综述报告了与生理盐水相比，地塞米松的给药在减少术中出血量、术后水肿和瘀斑方面具有有益的效果。
证据水平 III：本杂志要求作者为每篇文章分配一个证据级别。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
