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Published on: October 13, 2017
Preoperative Desmopressin for Bleeding Reduction During Rhinoplasty: A Systematic Review and Meta-Analysis of
Ramon Werner Heringer Gutierrez1, Helyel Rodrigues Gobbo2, Alexandre Yamada Fujimura Júnior3
1Federal University of Rio de Janeiro (UFRJ), 705, Sidnei Vasconcelos Aguiar Street, Macaé, Rio de Janeiro, 24804-703, Brazil. ramonwernerufrj@gmail.com.
Background:
Bleeding is a primary complication associated with rhinoplasty. The hemostatic effect of Desmopressin (DDAVP) in enhancing coagulation factors is being studied to prevent this complication in rhinoplasty patients.
Methods:
We performed a systematic review and meta-analysis of randomized clinical trials (RCTs) analyzing the effects of preoperative DDAVP during rhinoplasty. The outcomes evaluated were intraoperative bleeding and the quality of the surgical field.
Results:
Four studies comprising 262 rhinoplasty patients were included. Preoperative administration of intranasal DDAVP was associated with a significant reduction in total blood loss (MD = - 15.22 mL; 95% CI - 19.52 to - 10.93; p < 0.00001; I2 = 0%). Independent analyses also reported a significant improvement in the quality of the surgical field.
Conclusion:
DDAVP resulted in a statistically significant reduction in bleeding and a drier surgical field. However, the clinical significance remains to be established and further studies are required.
Level Of Evidence I:
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 .
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