Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty?

PURPOSE: Septorhinoplasty is a surgical procedure widely employed by otolaryngologists and plastic surgeons. The purpose of this study was to investigate the effects of a single pre-emptive dose of iv ibuprofen on postoperative pain and opioid consumption in patients undergoing septorhinoplasty. MATERIAL AND METHODS: 50 patients scheduled for septorhinoplasty were included in this prospective, randomized, double-blinded study. Control group (n = 25) was administered 100 mL iv saline solution 30 min preoperatively, while Ibuprofen group (n = 26) received 800 mg ibuprofen iv. in 100 mL saline solution. Intravenous fentanyl was administered with a Patient Controlled Analgesia device after surgery for postoperative pain management. Postoperative pain was evaluated using a Visual Analogue Scale (VAS) with 0 representing no pain and 10 the worst pain possible. RESULTS: VAS scores at 10, 20, and 30 min and at 1, 2, 4, 8, 12 and 24 h were lower in the ibuprofen group than in the control group (p < 0.05). Total fentanyl consumption was lower in the ibuprofen group compared to the placebo group (148.8 ±â€¯86.4 mcq vs 338.00 ±â€¯81.00 mcq), respectively. CONCLUSION: We suggest that the pre-emptive use of iv ibuprofen at a dosage of 800 mg 30 min before septorhinoplasty will be beneficial in reducing opioid consumption and pain scores.

Tracheal Rupture due to Diffusion of Nitrous Oxide to Cuff of High-Volume, Low-Pressure Intubation Tube.

Tracheal rupture is a rare complication of endotracheal intubation. Risk factors include short neck, repeated attempts due to failed intubation, inappropriate stylus, over-inflation of the cuff, poor positioning of the tube, inappropriate tube size, weakened membrane structure due to steroid use, chronic obstructive pulmonary disease, tracheomalacia, kyphosis, and use of nitric oxide during the operation. In this article, we suggest that high-volume, low-pressure tubes may not always provide a low-pressure effect and could rupture due to reduced tracheal perfusion pressure and ischemic damage upon over-inflation.