Prospective Randomized Trial Comparing Opioids versus Nonsteroidal Antiinflammatory Drugs for Postoperative Analgesia in Outpatient Rhinoplasty.


BACKGROUND:The misuse and abuse of opioids, including overprescription, has led to the current opioid epidemic and national crisis. There is a national effort to eliminate the unnecessary prescription of opioids for analgesia. METHODS:Seventy patients were randomized to receive postoperative analgesia with either 5 mg hydrocodone with 325 mg acetaminophen (opioid control group) or 400 mg of ibuprofen [nonsteroidal antiinflammatory drug (NSAID) experimental group]. Pain levels were assessed on postoperative days 1, 2, and 7. Outcome measures included numeric pain rating scores and assessments of frequency and amount of analgesic used. RESULTS:There was no significant difference in gender (p = 0.81) or age (p = 0.61) between groups. On postoperative day 0, the NSAID group (mean ± SD, 2.54 ± 1.57) was found to be noninferior to the opioid group (mean ± SD, 3.14 ± 1.75; p = 0.003). On postoperative day 1, the NSAID group showed a lower mean pain score (mean ± SD, 1.84 ± 1.29) than the opioid group (mean ± SD, 2.46 ± 1.90; p = 0.01). However, on postoperative day 7, the difference in pain scores between the NSAID (mean ± SD, 3.29 ± 2.14) and opioid (mean ± SD, 3.14 ± 2.12; p = 0.17) groups lost statistical significance. There was no significant difference in mean day of medication cessation between the NSAID (mean ± SD, 4.73 ± 1.57) and opioid (mean ± SD, 4.28 ± 2.23; p = 0.26) groups. Seventy-six percent of patients who were prescribed opioids took fewer than eight tablets. Five patients escalated from NSAIDs to opioids. There were no adverse effects related to NSAID use. CONCLUSIONS:NSAIDs are an acceptable and safe alternative to opioids for postoperative analgesia in rhinoplasty and potentially lead to better overall pain control in some patients. Significantly reducing or eliminating opioid prescriptions may be considered in light of the current opioid epidemic. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, II.


Plast Reconstr Surg


Frants A,Garber D,Lafer MP,Gordon SA,Markey JD,Zhang Y,Wang B,Lee JW




Has Abstract


2021-01-01 00:00:00














  • Effects of external beam irradiation on the TRAM flap: an experimental model.

    abstract::The rat model of the transverse rectus abdominis musculocutaneous (TRAM) flap was used in the present study to determine the effects of external beam radiation on myocutaneous flap histology and pathophysiology. A total of 57 adult Sprague-Dawley rats underwent a TRAM procedure. A pilot study with 17 animals was first...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Lin KY,Patterson JW,Simmons J,Long MD,Schultz RO,Amiss LR,Molloy JA,Kelly MD

    更新日期:2001-04-15 00:00:00

  • Improved survival of island flaps after prolonged ischemia by perfusion with superoxide dismutase.

    abstract::Perfusion of rat groin flaps after 10 and 11 hours of complete ischemia with superoxide dismutase, an oxygen free-radical scavenger, significantly improved the survival of these flaps. This finding provides further evidence for the important role that oxygen-derived free radicals play in ischemic injury. The study als...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Sagi A,Ferder M,Levens D,Strauch B

    更新日期:1986-04-01 00:00:00

  • Microvascular Reconstruction of the Nose with the Radial Forearm Flap: A 17-Year Experience in 47 Patients.

    abstract:BACKGROUND:Microvascular reconstruction of the nose was pioneered in China in the early 1970s using the radial forearm flap. Since then, different flaps, methods, and flap designs have been used to improve outcomes. Microvascular tissue transfer has become the first step of multistage reconstruction, which includes reb...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Salibian AH,Menick FJ,Talley J

    更新日期:2019-07-01 00:00:00

  • Total breast reconstruction using the thoracodorsal artery perforator flap without implant.

    abstract:BACKGROUND:The thoracodorsal artery perforator flap was described mainly for partial breast reconstruction by Hamdi. The purpose of this article is to describe the use of the pedicled thoracodorsal artery perforator flap for total autologous breast reconstruction without using an implant. METHODS:Between January of 20...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Santanelli F,Longo B,Germano S,Rubino C,Laporta R,Hamdi M

    更新日期:2014-02-01 00:00:00

  • Anchor-line abdominoplasty: a comprehensive approach to abdominal wall reconstruction and body contouring.

    abstract:BACKGROUND:Classic abdominoplasty leads to disappointing aesthetic results in patients with preexisting supraumbilical scars. Various techniques involving vertical and horizontal incisions have been described. The authors point out the validity of the "anchor-line" approach. METHODS:In a retrospective study, the autho...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Persichetti P,Simone P,Scuderi N

    更新日期:2005-07-01 00:00:00

  • Gluteal fold V-Y advancement flap for vulvar and vaginal reconstruction: a new flap.

    abstract:BACKGROUND:Soft-tissue reconstruction following vulvar cancer resection is a difficult challenge because of the functional, locational, and cosmetic importance of this region. Although numerous flaps have been designed for vulvar reconstruction, each has its disadvantages. METHODS:The authors introduce the gluteal fol...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Lee PK,Choi MS,Ahn ST,Oh DY,Rhie JW,Han KT

    更新日期:2006-08-01 00:00:00

  • Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps.

    abstract::The free anterolateral thigh flap is becoming one of the most preferred options for soft-tissue reconstruction. Between June of 1996 and August of 2000, 672 anterolateral thigh flaps were used in 660 patients at Chang Gung Memorial Hospital. Four hundred eighty-four anterolateral thigh flaps were used for head and nec...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Wei FC,Jain V,Celik N,Chen HC,Chuang DC,Lin CH

    更新日期:2002-06-01 00:00:00

  • Multiple occurrence of pilomatrixoma.

    abstract::Multiple occurrences of pilomatrixoma are rare. Although it has been known as a benign lesion, there are reports of some tumors that have histopathologic features of malignancy. A case of a 68-year-old Caucasian women with multiple pilomatrixoma is presented. She was operated on to remove three other pilomatrixomas on...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Aslan G,Erdoğan B,Aköz T,Görgü M,Seçkin S,Terzioğlu A

    更新日期:1996-09-01 00:00:00

  • Auricular reconstruction: indications for autogenous and prosthetic techniques.

    abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Describe the alternatives for auricular reconstruction. 2. Discuss the pros and cons of autogenous reconstruction of total or subtotal auricular defects. 3. Enumerate the indications for prosthetic reconstruction of total or subtotal...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Thorne CH,Brecht LE,Bradley JP,Levine JP,Hammerschlag P,Longaker MT

    更新日期:2001-04-15 00:00:00

  • Primary closure of trochanteric decubitus ulcers: the bipedicle tensor fascia lata musculocutaneous flap.

    abstract::A surgical procedure is described for the definitive treatment of trochanteric decubitus ulcers. It combines the advantages of the bipedicle skin flap and the musculocutaneous flap; that is, a large area of skin is provided with a thick protective padding consisting of fat, fascia, and muscle richly vascularized by th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Schulman NH

    更新日期:1980-11-01 00:00:00

  • Syngeneic Transplantation of Rat Olfactory Stem Cells in a Vein Conduit Improves Facial Movements and Reduces Synkinesis after Facial Nerve Injury.

    abstract:BACKGROUND:Posttraumatic facial paralysis is a disabling condition. Current surgical management by faciofacial nerve suture provides limited recovery. To improve the outcome, the authors evaluated an add-on strategy based on a syngeneic transplantation of nasal olfactory stem cells in a rat model of facial nerve injury...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Bense F,Montava M,Duclos C,Bisson A,Delarue Q,Mardion NB,Boyer O,Féron F,Guérout N,Marie JP

    更新日期:2020-12-01 00:00:00

  • Force-induced craniosynostosis in the murine sagittal suture.

    abstract:BACKGROUND:The cause of nonsyndromic craniosynostosis remains elusive. Although compressive forces have been implicated in premature suture fusion, conclusive evidence of force-induced craniosynostosis is lacking. The purpose of this study was to determine whether cyclical loading of the murine calvaria could induce su...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Oppenheimer AJ,Rhee ST,Goldstein SA,Buchman SR

    更新日期:2009-12-01 00:00:00

  • Sensation recovery on innervated radial forearm flap for hemiglossectomy reconstruction by using different recipient nerves.

    abstract::The objectives of this study were (1) to determine the extent of sensory recovery on hemitongues reconstructed with innervated radial forearm flaps and (2) to assess the influence of various clinical and surgical factors over the return of sensation, including the use of different recipient nerves for neurorrhaphy. Tw...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Santamaria E,Wei FC,Chen IH,Chuang DC

    更新日期:1999-02-01 00:00:00

  • Treatment of burn alopecia with tissue expanders in children.

    abstract::During the past 18 months, 60 tissue expanders were utilized in the reconstruction of 42 children with burn alopecia of the scalp not amenable to a single excision and primary closure at the Shriners Burns Institute in Galveston, Texas. The children were grouped according to the degree of alopecia. All patients with d...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Buhrer DP,Huang TT,Yee HW,Blackwell SJ

    更新日期:1988-04-01 00:00:00

  • A simple instrument for achieving accurate alignment and pre-insertion stability with mandibular bone plates.

    abstract::The modified Dingman forceps provides several advantages over currently designed plate-holding forceps. The rubber tubing prevents metal-to-metal contact of the forceps on the plate and provides increased stability to the plate. The long lingual jaws of the Dingman forceps are applied to the lingual bone at a point re...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Schmitz JP,Hollinger JO

    更新日期:1986-12-01 00:00:00

  • Anatomical localization of the umbilicus: an Indian study.

    abstract:BACKGROUND:The umbilicus is essential to the aesthetic appearance of the abdomen. However, very little has been written about the exact location of the aesthetically pleasing umbilicus as far as the Indian cosmopolitan population is concerned. Although a variety of reconstructive methods are available, no real standard...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Abhyankar SV,Rajguru AG,Patil PA

    更新日期:2006-04-01 00:00:00

  • Assessment of skin flaps using optically based methods for measuring blood flow and oxygenation.

    abstract::The objective of this study was to compare two noninvasive techniques, laser Doppler and optical spectroscopy, for monitoring hemodynamic changes in skin flaps. Animal models for assessing these changes in microvascular free flaps and pedicle flaps were investigated. A 2 x 3-cm free flap model based on the epigastric ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Payette JR,Kohlenberg E,Leonardi L,Pabbies A,Kerr P,Liu KZ,Sowa MG

    更新日期:2005-02-01 00:00:00

  • In vitro murine posterior frontal suture fate is age-dependent: implications for cranial suture biology.

    abstract::In CD-1 mice, the posterior frontal suture (analogous to the human metopic suture) fuses while all other cranial sutures remain patent. In an in vitro organ culture model, the authors previously demonstrated that posterior frontal sutures explanted immediately before the onset of suture fusion (at 25 days old) mimic i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Song HM,Sahar DE,Fong KD,Nacamuli RP,Fang TD,Mathy JA,Aalami OO,Warren SM,Longaker MT

    更新日期:2004-04-01 00:00:00

  • Diastematomyelia: a congenital anomaly not to be confused with a giant hairy nevus.

    abstract::The role of the plastic surgeon in the diagnosis and management of congenital anomalies is often a complicated one that involves the integration of input from numerous specialists into the evaluation process. Diastematomyelia is a serious neurosurgical problem that often presents with cutaneous findings in a neurologi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Weinzweig J,Holman PD,Rekate HL

    更新日期:1995-07-01 00:00:00

  • Efficacy of antibodies against the N-terminal of Pseudomonas aeruginosa flagellin for treating infections in a murine burn wound model.

    abstract:BACKGROUND:In an era of increasing drug resistance, immunotherapy is a desirable treatment against Pseudomonas aeruginosa infections. The flagellum, which is an important pseudomonal virulence factor, was targeted for immunotherapy. The aim of the study was to evaluate the efficacy of polyclonal immunotherapy targeted ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Barnea Y,Carmeli Y,Gur E,Kuzmenko B,Gat A,Neville LF,Eren R,Dagan S,Navon-Venezia S

    更新日期:2006-06-01 00:00:00

  • The tissue effects of ultrasound-assisted lipoplasty.

    abstract::The objective of our study was to investigate the effects of ultrasonic energy on tissues, using a porcine model, performed under various instrumental and procedural parameters. Domestic pigs were anesthetized and prepared for surgery. An incision was made on the side of the hip randomly assigned to the right or left ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Kenkel JM,Robinson JB Jr,Beran SJ,Tan J,Howard BK,Zocchi ML,Rohrich RJ

    更新日期:1998-07-01 00:00:00

  • Management of Vascular Anomalies and Related Conditions Using Suction-Assisted Tissue Removal.

    abstract:UNLABELLED:Vascular anomalies and related conditions cause overgrowth of tissues. The purpose of this study was to determine the efficacy and safety of liposuction techniques for pediatric overgrowth diseases. Patients treated between 2007 and 2015 who had follow-up were reviewed. Seventeen patients were included; the ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Couto JA,Maclellan RA,Greene AK

    更新日期:2015-10-01 00:00:00

  • Introduction of microsurgery in Vietnam by a charitable organization: a 15-year experience.

    abstract:BACKGROUND:Microsurgical procedures, although equipment- and labor-intensive, allow efficient treatment of selected soft-tissue, bone, and peripheral nerve defects. The precise surgical skills required and the high equipment and institutional costs have been deterrents to initiating programs in developing countries. Th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Merrell JC,Tien NV,Son NT,An LN,Sellers D,Russell R,Manktelow R,Wei FC,Orgill DP

    更新日期:2007-04-01 00:00:00

  • Operative management and outcome of complex wounds following total knee arthroplasty.

    abstract::This study describes the treatment protocol for and the outcome of the management of complex wounds around total knee replacements. An analysis of 28 patients (29 knees) with complex defects who had surgery between January 1, 1986, and July 30, 1996, was performed. A specific management protocol was applied to each kn...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Nahabedian MY,Mont MA,Orlando JC,Delanois RE,Hungerford DS

    更新日期:1999-11-01 00:00:00

  • Effects of sodium pentobarbital anesthesia on blood flow in skin, myocutaneous, and fasciocutaneous flaps in swine.

    abstract::Drug effect on flap blood flow is most commonly determined in anesthetized animals, yet the effect of the anesthetic is often poorly understood. Halothane and nitrous oxide cause profound changes in skin blood flow and thus provide an unsuitable anesthetic technique for use in measuring drug effects on skin and myocut...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Thomson JG,Kerrigan CL,Abrahamowicz M

    更新日期:1991-08-01 00:00:00

  • Development of a new documentation system for facial movements as a basis for the international registry for neuromuscular reconstruction in the face.

    abstract::None of the paresis scoring systems used satisfies an adequate description of all the details necessary to document the degree of facial paresis before and after any treatment. We developed a new documentation system considering all details of the history of the patient and of the treatment that could have any influen...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Frey M,Jenny A,Giovanoli P,Stüssi E

    更新日期:1994-06-01 00:00:00

  • Posterior tibial artery flap for reconstruction of the esophagus.

    abstract::Three patients presented who needed reconstruction of the entire esophagus. Because the stomach and colon were not available in these patients, a posterior tibial artery flap was employed for reconstruction. In the first stage, the long and wide skin flap was elaborated into a skin tube to create the major portion of ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Chen HC,Tang YB,Noordhoff MS

    更新日期:1991-12-01 00:00:00

  • Shaped versus Round Implants in Breast Reconstruction: A Multi-Institutional Comparison of Surgical and Patient-Reported Outcomes.

    abstract:BACKGROUND:Since the 2012 approval of shaped implants, their use in breast reconstruction has increased in the United States. However, large-scale comparisons of complications and patient-reported outcomes are lacking. The authors endeavored to compare surgical and patient-reported outcomes across implant types. METHO...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,多中心研究


    authors: Khavanin N,Clemens MW,Pusic AL,Fine NA,Hamill JB,Kim HM,Qi J,Wilkins EG,Kim JYS

    更新日期:2017-05-01 00:00:00

  • Rat ear reattachment as an animal model.

    abstract::The external ear of the rat is an excellent model for practicing microsurgical dissection and for the refinement of microvascular anastomoses, techniques that are crucial for microvascular en bloc tissue transfer and replantation. Preparation of the rat ear for replantation requires familiarity with the vascular anato...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Chiu DT,Chen L,Chen ZW

    更新日期:1990-05-01 00:00:00

  • Management of Stenosing Flexor Tenosynovitis: Maximizing Nonoperative Success without Increasing Morbidity.

    abstract:BACKGROUND:Traditional nonoperative management of stenosing tenosynovitis is limited to one corticosteroid injection, followed by surgery in the case of failure. Recently, nonoperative strategies have been extended to include two or three injections despite the absence of large prospective studies supporting this pract...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Golas AR,Marcus LR,Reiffel RS

    更新日期:2016-02-01 00:00:00