Postoperative Pain Management in Rhinoplasty: A Double Blind Randomized Controlled Trial - UTU Research Portal

A1 Refereed original research article in a scientific journal

Postoperative Pain Management in Rhinoplasty: A Double Blind Randomized Controlled Trial

Authors: Kandathil, Cherian Kurian; Spataro, Emily A.; Saltychev, Mikhail; Kalebjian, Roushig; Patel, Priyesh N.; Kim, Cherine H.; Akkina, Sarah R.; Kimura, Kyle S.; Rossi-Meyer, Monica; Longino, Elizabeth S.; Truong, Henry; Most, Sam P.

Publisher: Mary Ann Liebert

Publication year: 2026

Journal: Facial Plastic Surgery & Aesthetic Medicine

Article number: 26893614261429310

ISSN: 2689-3614

eISSN: 2689-3622

DOI: https://doi.org/10.1177/26893614261429310

Publication's open availability at the time of reporting: No Open Access

Publication channel's open availability : Partially Open Access publication channel

Web address : https://doi.org/10.1177/26893614261429310

Abstract

Background:

There is inadequate evidence for the utilization of nonnarcotic pain medications for postoperative pain management following rhinoplasty.

Objective:

To compare the effectiveness of opioid and non-opioid medications for postoperative pain control in rhinoplasty as measured by a visual analog scale (VAS) on postoperative days 0–5.

Methods:

In this double-blind randomized controlled clinical trial, adult patients who underwent primary rhinoplasty at a tertiary center were enrolled from August 2019 to October 2024. Patients were randomized to receive either a combination of acetaminophen (325 mg) and hydrocodone (5 mg) or acetaminophen (325 mg) and ibuprofen (200 mg), 1–2 tablets every 4 h for five postoperative days. Tramadol (50 mg) was prescribed for breakthrough pain.

Results:

A total of 130 patients (65 per group) completed the study. The average age (SD) was 32 (10.7) years. The majority were women (77%), White (68%), and underwent combined functional and aesthetic rhinoplasty (52%). There was no difference detected in mean postoperative pain (VAS) scores recorded on postoperative days 0–5, between treatment groups (p = 0.156). Among side effects, only itchiness was significantly higher (p = 0.001) in the hydrocodone–acetaminophen group.

Conclusion:

This trial demonstrates a lack of difference between opioid and non-opioid pain medications in postoperative pain control after rhinoplasty.

Funding information in the publication:
No funding was received for this article.