Opioid-Sparing Pain Control after Rhinoplasty: Updated Review of the Literature.

Area of Science:

• Plastic Surgery
• Pain Management
• Pharmacology

Background:

• Rhinoplasty is a common elective surgery with significant potential for opioid overprescription.
• The opioid crisis necessitates effective pain management strategies that reduce reliance on opioids.
• Inadequate pain control post-surgery can lead to patient dissatisfaction and negative postoperative experiences.

Approach:

• Implementing perioperative interventions at preoperative, intraoperative, and postoperative stages.
• Utilizing multimodal opioid-sparing techniques: acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and gabapentin.
• Employing preoperative counseling, intraoperative nerve blocks, long-acting analgesia, and modified surgical techniques.

Key Points:

• Opioid overprescription is common in rhinoplasty, with patients often using less than 50% of prescribed medication.
• Excess opioids pose risks for misuse and diversion.
• Multimodal pain management optimizes postoperative outcomes and minimizes opioid requirements.

Conclusions:

• Rhinoplasty is amenable to opioid minimization through standardized perioperative interventions.
• A multimodal approach, reserving opioids for rescue analgesia, is recommended for effective pain control.
• Successful pain management balances limiting opioid overuse with preventing inadequate pain relief.