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Article Type

Article

Abstract

Background and Objectives: Septoplasty is one of the most common surgical procedures in specialty of otorhinolaryngology. Therefore there are frequent thoughts regarding this procedure to improve its conditions from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. One of big issues regarding this procedure is the post-operative sequel and complications namely post-operative pain, oro-facial edema, , air way obstruction, epistaxis, nausea and vomiting, nasal obstruction, atrophic rhinitis, induction of allergic rhinitis, septal perforation and synachia formation. Therefore this study was conducted prospectively to confirm the effect of intravenous administration of dexamethasone on outcomes of this procedure as compared to the effect of oral administration of ketoprofen as well as paracetamol after septoplasty procedure.

Patients and Methods: 591 patients aged from 6 years to 65 years presented at ENT department –Althowra central teaching hospital as well as Altarahom private clinic – elbyda city – Libya at period in between September 2005 to January 2013 as cases of DNS with variable patterns of septal deformities for septoplasty. 147 patients were received oral paracetamol who represent group-A, 200 received oral ketoprofen that constitutes group-B, while remaining 244 were administrated by intravenous dexamethasone and classified as group-C. As prospective analytic study, three groups compared in relation to significant postoperative complications risk namely post-operative pain, oro-facial edema, , air way obstruction, epistaxis, nausea and vomiting, nasal obstruction, atrophic rhinitis, induction of allergic rhinitis, septal perforation and synachia formation. In addition these groups compared for any significant difference regarding the period of postoperative hospitalization which can be used as objective indicator to measure the postoperative morbidity rate.

Results: Dexamethasone as well as ketoprofen administration caused significant improvement in pain intensity as compared to paracetamol group. On the other hand there was significant reduction in the incidence of post-operative oro-facial edema , air way obstruction, epistaxis, nausea and vomiting, nasal obstruction, atrophic rhinitis, induction of allergic rhinitis, septal perforation and synachia formation among group-B and C as compared to group-A.

Conclusion: Generally speaking dexamethasone can be considered as potent analgesic drug after septoplasty procedure and in same time it plays significant role in the improvement of outcomes of this common procedure as compared to the other commonly used non-steroidal anti-inflammatory drugs.

Keywords: Post-septoplasty analgesia, post- septoplasty dexamethasone administration.

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