May 14, 2015
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Smaller doses of desmopressin maintain ability to create drier operative field in rhinoplasty

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Desmopressin given at lower-than-normally-used doses was shown to create a dryer operative field during rhinoplasty, which can lead to more precise surgery and less tip induration postoperatively, according to researchers.

Seventy-three patients undergoing rhinoplasty received desmopressin at 0.1 µg/kg intravenously 30 minutes prior to surgery. A second dose of the same amount was given if the operative field was wet or less dry than desired during surgery. If, after 30 minutes, the field was still not as dry as desired, a third dose was given.

A control group of 300 consecutive primary and secondary rhinoplasties where no desmopressin was used was also included in the study.

Thirty patients in the desmopressin group received the initial dose and no additional doses. Fourteen received a second dose, and 29 received a third dose. In all cases where desmopressin was used, the patients exhibited a satisfactory dry operative field as determined by the surgeon. In comparison, only nine patients in the control group exhibited a satisfactory dry operative field, according to the researchers.

Postoperatively, none of the patients developed epistaxis; however, no notation of the extent of postoperative bloody nasal drip was made.

The researchers found no complications and no symptoms to suggest hyponatremia.

In the non-desmopressin group, comments were noted for 28 patients about a wet operative field and difficulty achieving hemostasis or oozing that hampered the field.

The researchers concluded smaller-than-average doses may be sufficient to achieve a dryer operative field. - by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.