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Effectiveness of Bleeding Control Methods in Rhinoplasty: A Systematic Review and Meta-Analysis.

Mohammad Reza Zamani¹, Behzad Imani², Rohollah Abbasi³

¹Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.

Archives of Plastic Surgery

|February 2, 2026

Summary

This summary is machine-generated.

Tranexamic acid (TXA) and steroids significantly reduce bleeding during rhinoplasty surgery. Patient positioning also helps control intraoperative blood loss, improving surgical outcomes.

Keywords:

intraoperative bleeding meta-analysis rhinoplasty septorhinoplasty systematic review

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Area of Science:

Plastic Surgery
Anesthesiology
Evidence-Based Medicine

Background:

Intraoperative bleeding is a common complication in rhinoplasty and septorhinoplasty.
Effective bleeding control is crucial for surgical success and patient safety.

Purpose of the Study:

To systematically review and meta-analyze the efficacy of various methods for controlling intraoperative bleeding during rhinoplasty and septorhinoplasty.

Main Methods:

Systematic review and meta-analysis adhering to PRISMA guidelines.
Included 16 randomized controlled trials (RCTs) involving 933 patients.
Evaluated tranexamic acid (TXA), desmopressin, steroids, magnesium sulfate, clonidine, remifentanil, and patient positioning.

Main Results:

Tranexamic acid (TXA) and steroids demonstrated the most significant reduction in bleeding (SMD: -1.31 and -1.07, respectively).
Patient positioning (reverse Trendelenburg) showed a considerable effect (SMD: -0.65).
Desmopressin showed a positive trend but was not statistically significant (SMD: -1.53).

Conclusions:

Pharmacological (TXA) and non-pharmacological (patient positioning) interventions effectively reduce intraoperative bleeding in rhinoplasty.
Further research with larger sample sizes is recommended for evaluating magnesium sulfate, clonidine, and remifentanil.