This study will be a prospective randomized study to evaluate the effect of medrol
dosepaks (oral corticosteroids) on postoperative outcomes among patients undergoing
rhinoplasty by Facial Plastic Surgeons at Vanderbilt. Outcomes will include postoperative
pain, nausea, and patient experience, with secondary outcomes of swelling and bruising.
Methylprednisolone is an oral corticosteroid that has been shown in multiple RCTs and is
used extensively that it can significantly reduce postoperative swelling and bruising in
postoperative rhinoplasty patients, however, we have not examined if those effects extend
to their pain ratings, nausea, and overall patient experience. Current research on use of
steroids in rhinoplasty suggests that its use may decrease pain and nausea and benefit
the patients overall experience.
Minimizing complications for any surgery is of upmost importance for surgeons.. However,
the benefits of oral corticosteroid use for rhinoplasty patients in the immediate
post-operative period are poorly understood and practice patterns vary widely. To
identify and quantify the benefits and drawbacks of oral corticosteroid use in the
immediate post-operative period for primary rhinoplasty patients, pain, swelling, nausea,
patient experience, and post-operative swelling will be studied.
Rhinoplasty is a popular but challenging surgery. To date, there has been very little
evidence on how using medrol in the postoperative period benefits a patient in terms of
pain, nausea and their overall experience. The procedure is often associated with pain,
edema, bruising and postoperative nausea. We currently do use oral corticosteroids for
prevention of postoperative edema and ecchymosis however, we don't have a clear idea on
how use of postoperative oral steroids effects pain, nausea and the overall patient
experience. This study would like to add to the body of knowledge on oral corticosteroid
use in the perioperative rhinoplasty period. It would be a simple, inexpensive study that
may have significant benefit for future patients and surgeons. This medication is already
used and has an established safety profile. This study would simply randomize patients to
treatment vs placebo to determine if any real benefit exists, in an effort to determine
if this practice should be standardized and universally applied in the future, or deemed
unnecessary.
The prospective participants are patients who choose to undergo elective rhinoplasty
surgery with one of three attending surgeons in the division of Facial Plastic Surgery
within the Department of Otolaryngology/Head and Neck Surgery at Vanderbilt University
Medical Center. Patients who elect to undergo surgery will be informed of the study and
offered the opportunity to volunteer to participate in person either during the
preoperative clinic visit OR in the preoperative area on the day of surgery. They will be
led through an informed consent process, and excluded if they meet any of the exclusion
criteria. Patients will be placed in the intervention group if their MRN is even and in
the no intervention group if their MRN is odd.
The patients will be met on the day of surgery by a research coordinator, who is one of
the study's KSP. The research coordinator will be responsible for screening the patients
and determining eligibility based on the inclusion/exclusion criteria above. All
participation will be strictly voluntary and will require informed consent.