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














  • In-Depth Look at the Anatomical Relationship of the Lesser Occipital Nerve, Great Auricular Nerve, and Spinal Accessory Nerve and Their Implication in Safety of Operations in the Posterior Triangle of the Neck.

    abstract:BACKGROUND:Migraine surgery is an increasingly popular treatment option for migraine patients. The lesser occipital nerve is a common trigger point for headache abnormalities, but there is a paucity of research regarding the lesser occipital nerve and its intimate association with the spinal accessory nerve. METHODS:S...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Amirlak B,Lu KB,Erickson CR,Sanniec K,Totonchi A,Peled ZM,Cheng JC

    更新日期:2020-09-01 00:00:00

  • Surgical Management of Obstructive Sleep Apnea.

    abstract::Surgical management of snoring and obstructive sleep apnea is indicated when a surgically correctable abnormality is believed to be the source of the problem. Many patients opt for surgical treatment after noninvasive forms of treatment have been proven ineffective or difficult to tolerate. With increasing frequency, ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审


    authors: Tanna N,Smith BD,Zapanta PE,Karanetz I,Andrews BT,Urata MM,Bradley JP

    更新日期:2016-04-01 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

  • Biology and Biomarkers for Wound Healing.

    abstract:BACKGROUND:As the population grows older, the incidence and prevalence of conditions that lead to a predisposition for poor wound healing also increase. Ultimately, this increase in nonhealing wounds has led to significant morbidity and mortality with subsequent huge economic ramifications. Therefore, understanding spe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审


    authors: Lindley LE,Stojadinovic O,Pastar I,Tomic-Canic M

    更新日期:2016-09-01 00:00:00

  • Primary toe-to-thumb transfer in the acutely avulsed thumb.

    abstract::The case is presented of a primary toe-to-thumb transfer by microvascular anastomosis for reconstruction of an acute degloving amputation of the thumb. This approach is not recommended as the standard practice for this type injury, however, there were certain advantages in this patient: (1) one stage procedure, (2) re...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Rose EH,Hendel P

    更新日期:1981-02-01 00:00:00

  • Proximal peroneal perforator in dual-skin paddle configuration of fibula free flap for composite oral reconstruction.

    abstract:BACKGROUND:Composite defects of the oral cavity are often the result of trauma or advanced-stage tumor extirpation. The resultant deformity frequently requires a three-dimensional reconstruction of bone and soft-tissue. The fibula free flap is the preferred method of reconstruction, with various modifications focused o...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Potter JK,Lee MR,Oxford L,Wong C,Saint-Cyr M

    更新日期:2014-06-01 00:00:00

  • Microvascular polytetrafluoroethylene prostheses: the cellular events of healing and prostacyclin production.

    abstract::This study was undertaken to obtain more insight into the morphologic and functional performance of microvascular polytetrafluoroethylene (PTFE) prostheses. Therefore, both the cellular events of healing (n = 30) and the prostacyclin production (n = 18) of microvascular polytetrafluoroethylene prostheses (length 10 mm...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: van der Lei B,Wildevuur CR

    更新日期:1988-05-01 00:00:00

  • Application of high-tech three-dimensional imaging and computer-generated models in complex facial reconstructions with vascularized bone grafts.

    abstract::We present a series of six patients with eight flaps in whom computer-generated models were used for fabrication of vascularized bone grafts in complex facial restorations. Preoperative CT data, digitalized on tape, were converted by the CEMAX (Santa Clara, Calif.) 1500 Integrated Hardware and Software System to a thr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Rose EH,Norris MS,Rosen JM

    更新日期:1993-02-01 00:00:00

  • Fungi in and around implants after augmentation mammaplasty.

    abstract::Four cases of possible fungal infections after 700 augmentation mammaplasties are presented in a 9-year experience. The source could not be determined. If any readers have had one or more similar cases, we would appreciate your contacting us. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Truppman ES,Ellenby JD,Schwartz BM

    更新日期:1979-12-01 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

  • Inappropriate antidiuretic hormone syndrome in craniofacial surgery.

    abstract::Three instances of inappropriate ADH syndrome following craniofacial operations are reported. The cornerstone to diagnosis is careful fluid and electrolyte monitoring. Treatment consists of fluid restrictions in the acute phase and demeclocycline for refractory cases. Seizures should be symptomatically treated. Surgeo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Brones MF,Kawamoto HK Jr,Renaudin J

    更新日期:1983-01-01 00:00:00

  • APACHE II scoring for the prediction of immediate surgical complications in head and neck cancer patients.

    abstract:BACKGROUND:Aggressive surgical treatment of oral and oropharyngeal cancers may be compromised by significant surgical complications. Early identification of patients at risk for postoperative complications may assist in clinical decision-making. The objective of this study was to assess the value of the Acute Physiolog...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Grant CA,Dempsey GA,Lowe D,Brown JS,Vaughan ED,Rogers SN

    更新日期:2007-05-01 00:00:00

  • The chin: skeletal and soft-tissue components.

    abstract::The quantity of soft tissue overlying the symphysis menti affords an important attribute that can aid in determination of the correct surgical approach for optimal facial harmony. Xerograms of the facial profile of 100 patients with normal occlusion were analyzed by accepted radiographic cephalometric techniques. The ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Michelow BJ,Guyuron B

    更新日期:1995-03-01 00:00:00

  • Effect of a transpositional muscle flap on VEGF mRNA expression in a canine fracture model.

    abstract::The effect of sepsis on neovascularization in fractures that follows open fractures is important to the understanding of bone and soft-tissue healing. An animal model was designed that mimics the open fracture and the clinical repair of the human, high-energy open fracture. Vascular endothelial growth factor (VEGF) mR...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Khodaparast O,Coberly DM,Mathey J,Rohrich RJ,Levin LS,Brown SA

    更新日期:2003-07-01 00:00:00

  • What is the optimal time to start helmet therapy in positional plagiocephaly?

    abstract:BACKGROUND:Although helmet therapy is widely accepted in the treatment of severe positional plagiocephaly, treatment regimens, especially regarding starting age, are controversial. This study investigated the importance of starting age to optimize the management of helmet therapy. METHODS:Sixty-two infants with severe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Kluba S,Kraut W,Reinert S,Krimmel M

    更新日期:2011-08-01 00:00:00

  • Facial reconstruction with free-tissue transfer.

    abstract::The article provides a retrospective review of 25 free-tissue transfers for facial reconstruction on 24 recipient sites in 21 patients. The recipient sites of the face were classified into frontal (4 patients), orbital (2 patients), nasal (2 patients), buccal (11 patients), and oral region (5 patients). The transferre...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Yamamoto Y,Minakawa H,Sugihara T,Shintomi Y,Nohira K,Yoshida T,Igawa H,Ohura T

    更新日期:1994-09-01 00:00:00

  • Evidence-based medicine: Unilateral cleft lip and nose repair.

    abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Describe the anatomical malformations found in unilateral cleft lip deformity. 2. Discuss current methods of measuring the deformity and subsequent outcomes. 3. Discuss preoperative assessments, workup, and the use of early interventi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审


    authors: Greives MR,Camison L,Losee JE

    更新日期:2014-12-01 00:00:00

  • Not All Gustilo Type IIIB Fractures Are Created Equal: Arterial Injury Impacts Limb Salvage Outcomes.

    abstract:BACKGROUND:Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical out...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Stranix JT,Lee ZH,Jacoby A,Anzai L,Avraham T,Thanik VD,Saadeh PB,Levine JP

    更新日期:2017-11-01 00:00:00

  • Videoscope-Assisted Cleft Palate Surgery: Rationale, Experience, and Technical Implementation.

    abstract::Limited visibility characteristic of cleft palate repair presents both ergonomic and educational challenges to cleft surgeons. Despite widespread recognition and reporting, posture-related spine disorders continue to represent a significant and potentially career-limiting problem for cleft/craniofacial surgeons. In ad...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Levites HA,Sergesketter AR,Sharif-Askary B,Hollenbeck ST,Allori AC,Marcus JR

    更新日期:2020-11-01 00:00:00

  • Use of the vascularized free fibula graft with an arteriovenous loop for fusion of cervical and thoracic spinal defects in previously irradiated pediatric patients.

    abstract:BACKGROUND:Extensive spinal neoplasms are difficult to manage. Following resection, arthrodesis of the spine can be performed with instrumentation, but this often fails in the setting of radiation therapy. Use of the free fibula flap for anterior spinal fusion to correct deformities has been described in multiple studi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Jandali S,Diluna ML,Storm PB,Low DW

    更新日期:2011-05-01 00:00:00

  • The association between breast surgeons' attitudes toward breast reconstruction and their reconstruction-related information-giving behaviors: a nationwide survey in Japan.

    abstract:BACKGROUND:Breast reconstruction after breast cancer surgery has come to be regarded as an achievable treatment option to improve patients' quality of life. Although it has been pointed out that surgeons' information-giving behaviors affect women's decision to undergo breast reconstruction surgery, little is known abou...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Takahashi M,Kai I,Hisata M,Higashi Y

    更新日期:2006-12-01 00:00:00

  • Infracture technique for reduction malarplasty with a short preauricular incision.

    abstract::The infracture technique for reduction malarplasty has been widely used as an aesthetic surgical procedure in northeast Asia. Since 1988, the authors' original method of infracture technique was performed through the combined approach of intraoral and temporopreauricular incision, which may leave a rather long scar on...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Yang DB,Chung JY

    更新日期:2004-04-01 00:00:00

  • High-Throughput Screening of Full-Face Clinically Relevant Arterial Variations Using Three-Dimensional Postmortem Computed Tomography.

    abstract:BACKGROUND:Vascular complications resulting from intravascular filler injection and embolism are major safety concerns for facial filler injection. It is essential to systematically screen full-face arterial variations and help design evidence-based safe filler injection protocols. METHODS:The carotid arteries of 22 c...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Zhu GZ,Zhao WR,Luo CE,Cai B,Kong XX,Zhan WF,Sun ZS,Luo SK

    更新日期:2018-11-01 00:00:00

  • Breast pathology and reduction mammaplasty.

    abstract::Breast cancer is the tumor with the highest prevalence and incidence in women. Reduction mammaplasty is one of the most common procedures performed in Brazil by the plastic surgeon, and it is not uncommon for the surgeon to find a breast tumor during the operation or afterward, when the histopathological report is rec...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Pitanguy I,Torres E,Salgado F,Pires Viana GA

    更新日期:2005-03-01 00:00:00

  • Aesthetic surgery: effects of rhinoplasty on the social perception of patients by others.

    abstract::Based on contemporary social psychological theory and research, the aesthetic appeal of one's physical appearance can have considerable influence on others--on social attraction, attitudes, attributions, and actions, which in turn can affect one's psychosocial experiences and development. From this perspective, the pr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Cash TF,Horton CE

    更新日期:1983-10-01 00:00:00

  • The incidence of late cephalohematoma following craniofacial surgery.

    abstract:BACKGROUND:Cranial vault remodeling procedures are carried out for both syndromic and nonsyndromic craniosynostosis as well as to correct some acquired deformities of the cranial vault. These procedures improve not only cosmesis but also neurological symptoms. The purpose of this study was to determine the incidence of...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Ghali S,Knox KR,Boutros S,Thorne CH,McCarthy JG

    更新日期:2007-09-15 00:00:00

  • Dexmedetomidine in aesthetic facial surgery: improving anesthetic safety and efficacy.

    abstract:BACKGROUND:Dexmedetomidine is an alpha2-agonist anesthetic with several properties that are advantageous in aesthetic facial surgery. By attenuating sympathetic nervous system activity, it induces sedation and analgesia while lowering blood pressure and preventing pain-induced hemodynamic fluctuations. It spares the re...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: Taghinia AH,Shapiro FE,Slavin SA

    更新日期:2008-01-01 00:00:00

  • The effectiveness of mandibular distraction in improving airway obstruction in the pediatric population.

    abstract:BACKGROUND:Distraction osteogenesis is an effective technique for elongating the deficient mandible. The authors specifically evaluated its effectiveness in the treatment of airway obstruction in pediatric patients with mandibular hypoplasia. METHOD:A comprehensive literature review of the National Library of Medicine...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审


    authors: Tahiri Y,Viezel-Mathieu A,Aldekhayel S,Lee J,Gilardino M

    更新日期:2014-03-01 00:00:00

  • The Risk of Complications after Carpal Tunnel Release in Patients Taking Acetylsalicylic Acid as Platelet Inhibition: A Multicenter Propensity Score-Matched Study.

    abstract:BACKGROUND:Carpal tunnel release is one of the most common procedures in hand surgery. There is only scarce evidence regarding whether platelet inhibitors increase the risk of developing postoperative hemorrhage in carpal tunnel release. METHODS:This is a multicenter, propensity score-matched study including 635 carpa...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,多中心研究


    authors: Kaltenborn A,Frey-Wille S,Hoffmann S,Wille J,Schulze C,Settje A,Vogt PM,Gutcke A,Ruettermann M

    更新日期:2020-02-01 00:00:00

  • Sweet's syndrome presenting as acute hand infection.

    abstract:BACKGROUND:Sweet's syndrome, originally described as an acute febrile neutrophilic dermatosis, belongs to a class of skin lesions that histologically have intense epidermal and/or dermal inflammatory infiltrate of neutrophils without evidence of infection or vasculitis. Skin lesions of Sweet's syndrome most commonly pr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章


    authors: O'Halloran LE,Bennett LL,Grothaus PC,Lynch DJ

    更新日期:2005-08-01 00:00:00